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Chief Editor Dr. Kamath Madhusudhan

MD (Ayu)

Assistant Professor Department of Ayurveda KMC, Manipal

Email ID: Phone: 9448759365


From the desk of H. O. D.

Before the days of modern medicine, societies around the world had their own ways of preventing and treating illness. These were based on local beliefs, religion and culture. Ayurveda, is one such system. It started in India thousands of years ago with roots in the Indian culture and religion. Roughly translated, "Ayurveda" means "the science of life." It needed a scientific age for the world to appreciate the full dignity of Ayurveda as a holistic system of perfect health. Now it has become clear to the world of science that every thing in the universe has its basis in the unified field and everything can be successfully handled from this one area. It is this that has authenticated Ayurvedas holistic approach to perfect health for both individual and society. Ayurveda today stands as the technology of the unified field for perfect health of the individual of the nation, and of the world as a whole

Maharishi Mahesh Yogi


India has a large infrastructure for teaching and clinical care training under Indian systems of Medicine and teaching and training has been availed of according to the curriculum set up by the Central Council of Indian Medicine. The diagnosis and treatment of various ailments, use of drugs and Ayuvedic profession as a whole has its basis to the education based on authoritative texts recognized for these systems, but, the scientific validation of the treatment has not been done on a wide scale. The off take and output from these institutions has so far been limited and has not been able to meet the standards for scientific enquiry. In the present era of globalization and development of a world market for Ayurveda as a whole (education, research and medical care delivery), research and development is needed. Ayurvision is a step towards standardizing Ayurvedic Clinical practice, based on which depends the quality and standards of research. Indians. Every Indian has the right to protect it. Today, Too much emphasis is laid on modern medicine at the level of Ayurvedic education thereby neglecting Ayurvedic tradition and practice. Ayurvedic profession is looked down by the public greatly because graduates of Ayurveda sideline their science and resort to unethical practice of Modern Medicine, truly a sort of quackery. Emphasis needed to Ayurveda is Intellectual Property of we

improve the quality and standards of Ayurvedic Education, accountability of the Profession and standardization of Ayurvedic medicines. It is unfortunate that Graduates of Modern medicine are deprived of any knowledge of this science during their education. If an effort is made to expose students of modern medicine to the principles and practice of Ayurveda, either during their graduation level training or during their Internship period, we can hope for a better interaction among these practitioners in future. Medical Council of India, IMA and Central Council Of Indian Medicine should come to single platform and discuss this issue, as to how to implement this. Changing with times: In the meanwhile even the 20th century has passed. And we are fully aware of the

tremendous change that breath-taking advances of science and technology during this century


have brought upon human society, providing in particular the material basis of our health, illness and wellness, as well as present process of globalization. Ayurveda must open to advances in science and renew itself. The growth and continued

development of Ayurvedic knowledge however, suffered serious setbacks since 1500 years ago due to various historical reasons. Orthodoxy, dogmatism and superstitions began

creeping in to these intervening years and this glorious tradition began to lose its luster and credentials. During this long period of inertness and apathy a lot of filth and garbage had accumulated over such heritage, and Ayurveda lost its stature. It confronted with the

problems of fixing standards and specifications of identity, purity and strength. It can well be accomplished if Ayurveda adopts appropriate scientific methods and practices. But it does not mean that it should adopt the parameters of modern medicine in evaluating its quality and fixing standards as well as finding evidence. Evaluation and standardization of Ayurveda has to be based on the concept, theory, practice and parameters of Ayurveda only. Modern scientific knowledge, tolls and technology including information technology may be incorporated whenever needed and appropriate for Ayurveda. The Ayurvedic specialists are required to change their mindset and imbibe the spirit of scientific inquiry. Evidence based Ayurveda While talking of searching and applying evidence base to Ayurveda, we need to understand that in conventional sense, the term is primarily coined to help in clinical decision making in the light of best among overwhelmingly available evidences within modern medicine. Conventional modus operandi of applying evidence base to medical practice therefore is limited to screening of best evidences that help in decision making. Thereby, defining the best evidence and finding them pragmatically in a clinical setting are the only real challenges.

Referring to Ayurveda, however, the issue of applying evidence base needs to be redefined in reference to its unique propositions. There is a ubiquitous agreement upon the traditional evidences of Ayurveda of which experience, long-term use, and textual classical references form a large sum.


The issue of evidence base in Ayurveda therefore requires to be dealt at various levels like documentation of existing evidences, designing diagnostic and clinical parameters which can act as evidence to help in decision making and generating more evidences in reference to the safety and efficacy pertinent to Ayurvedic practice. This is the time when we need to understand that bringing evidence base to the practice of Ayurveda is mandatory if it is thought to be raised as a medical system where predictability and dependability are featured as key components. Ayurvedic Industry and Academia Ayurveda need more academic backup and evidence. I call upon Ayurveda Industry to strengthen and support academic research and clinical documentation of their products and standardizing the products to International standards, instead of simply adopting unconventional methods like advertising the products in lay magazines and news papers with unscientific methods and evidence less, false claims. These practices may lead to people

start looking at Ayurveda with a commercial angle and ultimately losing their faith and trust on the science itself. We need to build up Ayurvedic academic centers at par with Oxford or Cambridge University type of Institutions in India or abroad in future. " The future belongs to those who fuse intelligence with faith and who, with courage and determination, grope their way forward from chance to choice, from blind adaptation to creative evolution" - Charles Merriam Through this Ayuvision we propose to explore the new frontiers in academic and scientific Ayurveda.

Dr. M. S. Kamath MD (Ayu.) Additional Professor & Head Department of Ayurveda Manipal University KMC, Manipal. Tel. 0820 29 22105


1.Understanding the Doctrines & Dynamics of Vasti Karma Dr. ShyamakriShnan 20

2. The efficiency of Vasti Karma in every day practice: Expressing the experience Dr. a. S. PraShanTh.34






6.Abstracts of Oral Presentation.66

7.Esaay presentation..97



Symposium on '' The Doctrines and Empirical Dimensions of Vasti Karma"

25th & 26th November 2011

Chair person : Dr. Sripathi Rao Dean, KMC, Manipal.

Co- Chair

: Dr. M.S. Kamath HOD Dept. of Ayurveda, KMC, Manipal

Organizing Secretary:

Dr. Shripathi Adiga E Mail id: ;

Phone: 9449613039


Reception committee: Chairmen Dr. Anupama Dr. Sangeetha Dr. Nidhi Rathod Dr. Mahajan Mr. Manish Mr. Lohith Mr. Sathish Miss. Deepika Miss. Sowmya Mrs. Geetha Mrs. Laxmi Mr. Asif Mr. Ganesh Food & Catering Committee: Chairmen Dr. Basavaraj Dr. Sonam Pelmo Dr. Riddhida Sharma Dr. Harsha Dr. Kishan Mr. Prashanth Mr. Murali Miss. Sujaya Miss. Sowmya. S Mrs. Pushpalatha Mrs. Geetha

Transport Committee & Accommodation Chairmen Dr. Kkamath Madhusudana Dr. Mallikarjuna Dr. Harsha Dr. Priya Digra Dr. Savitri Mr. Ashwin Mr. Avinash Mrs. Sharada Miss. Ashwini Miss. Sumalatha Mrs. Sangeetha

Scientific Committee: Chairmen Dr. K.J. Malagi

Souvenir Committee (Ayurvision e-book): Chief Editor Dr. Kamath Madhusudhana


Papers from Reourse Persons.



1. Understanding the Doctrines & Dynamics of Vasti Karma

By, Dr. Shyamakrishnan,

Govt: Ayurveda Hospital, Venganoor, Muttakkad.po, Thiruvananthapuram 23 E Mail ID:



2. Principles of Vasti Dravya Kalpana

By, Dr. Vijay Kumar J. D.

Lecturer, Department of Panchakarma, KLE Ayurveda College and Hospital, Belguam, Karnataka E Mail ID:



3. The efficiency of Vasti Karma in every day practice: Expressing the experience


Dr. Prashanth. A.S.

Professor, Dept. of Kayachikitsa, Ayurveda Mahavidyalaya , Hubli, Karnataka E Mail ID:



4. A glimpse into the preventive and curative aspects of Vasti vyapaths


Dr. Mahesh P.S.

Medical Officer(Ayurveda), Govt. Ayurveda Dispensary, Meenja, P.O. Miyapadavu,Via Manjeshwar, Kasaragod Taluk & District- 671323, Kerala
E Mail ID:



5. An emperical approach to Uttara Vasti


Dr. Madhava Diggavi

Professor & Head, Dept. of Kayachikitsa, Taranath Govt. Ayurveda College Bellary, Karnataka E Mail ID :



6. Yapana Vasti: A critical approach


Dr. Pavana. J
Lecturer Department of Panchakarma PNNM Ayurveda College, Shornur Kerala Email:



7. Elucidating the probable mode of action of Vasti Karma


Dr. Gajanana Hegde

Professor and Head Department of Kayachikitsa GAMC Mysore , Karnataka E Mail ID :,



8. Use of contemporary analytical techniques for standardization of herbal preparations with respect to Vasti Karma By, Dr. Krishna Murthy Bhat

Professor and Head Department of Pharmaceutical Quality Assurance Manipal College of Pharmaceutical Sciences, MANIPAL 576 104. Phone: 0820-2922482 Mobile: +9198458 01575. Email:



9. Standard treatment protocols and scope for research in

Vasti Karma

By, Dr. A. K. Manoj

Professor & Head, Dept. of Panchakarma ,VPSV Ayurveda College Kottakkal, Kerala E Mail ID :




DR.G.SYAMAKRISHNAN, KERALA namaskRtya vaayave yathaazakti pravakSyaamaH
Let us pay obeisance to Lord Vayu and expound on the topic within our ken

In this era of emerging MICRO ENEMAS wherein 3 to 5 ml of aqueous solution of the drug is introduced rectally, the significance and review on the doctrines and dynamics of vasti karma in Ayurveda seems highly relevant. Vasti enjoys a high status in Ayurveda as the therapeutic procedure par excellence. It is designated as the half or even the whole treatment, because it incorporates the very basic principle of therapy in Ayurveda into it. The multitude of faculties, flexibility in its combinations, atypical media, wide applicability, rapid action and patient comfort makes this treatment unique among all others. It is phenomenal, but not properly studied by the Ayurveda intelligentsia. We need to address two basic questions as why and how, based on the objectives of ancient authorities of Ayurveda. When we scan through the classics of Ayurveda we need to review certain important doctrines which often we ignore purposefully, to become the so called modern and scientific. Being a very vast subject, only relevant points for discussion are dealt here. The medicament of vasti reaches only the lower abdomen. (CS.8.11.16) The medicament is not undergoing any metabolic transformation there and is evacuated immediately. (AH.1.5.54) It is intended to correct apana vaayu. Absorption of the medicament doesnt seem to be the intention of vasti, although it ensues in many times. Pharmaceutics of vasti itself is atypical.


The action of niruha is assigned as phenomenal. But it doesnt restrict the study of vasti in detail. Because the science appeals to engineer innumerable designer vastis as the condition demands, abiding to the textual references as examples. (SS.4.39.112).unlike other procedures, vasti is advised to be done under the supervision of a team of experts, probably due to its intricate nature and diverse ideas contribute to its proper application. The action is ascribed to its veerya (in Ayurveda, veerya is not only active principle, rather the dual basic qualities ushna and seeta and its combination with other guna). The wide systemic action is correlated with the sun, though very remote, exerting its influence over the earth by absorbing the water
(CS.8.7.64); And in another context, to cutting of a tree at its root, so that the

whole plant is destroyed (AS.1.28.7). Some of the classifications of vasti need review. Vasti can be applied as dosha specific (AS.5/ 4/53) and disease specific (AS. 5/4/54). Three types of vasti based on dosha -utklesanam, sudhikaram, samanam. And also vata haram, pitta haram and kapha haram. Two types of vasti based on veerya- ushna and seta (CS.8.1.35) (AH.5.4.71). It can be interpret based on the potency of the medicine, or based on the therapy as samtarpana and apatarpana or in a deeper sense of energy as prana and rayi related to Ida and pingala nadi of yoga. In the gross plane it may represent the autonomic nervous system. Two types of vasti based on guna - tikshna and mrudu. Many kashaya and kalka in vasti yoga are non specific medicines. e.g.: erandamoola and satapushpa in maadhutailikam are not specific for prameham or rasayanam.


The success sign explained are that of the procedure vasti regardless of the medicine used. Importance is given to success signs (represent optimum response from the body) and it is advised to repeat vasti till getting the success sign-kaphaantam (clear white mucus discharge) (Kasyapa-vasti
adhikaaram). It intends the expulsion of the material after a while and not of the

absorption of the medicament. The retention time is, till the patient gets the urge to defecate. The subject is advised to consciously wait for that. 48 minutes is the maximum time limit, and to act before complications arise. It is not the time to hold vasti. Effect of excessive administration of kashaya vasti is aggravation of vaata and that of anuvaasana and yaapana vasti is utklesa and Agni maandya. (CS.8.4.50). These are nonspecific to drugs used in it. The post operative procedure of kashaya vasti also aims at evacuation rather than retaining; whereas in anuvaasana aim is to divert the attention of patient by giving various stimuli, to prevent immediate evacuation and to retain it for some time. The quantity of vasti material ranges from approximately 1.5 palam (matra vasti) to 24 palam indicates that the intention is not absorption. The quantity of the vasti material is (one of the main factor) directly proportional to the intensity of sodhana. When quantity increases, sodhana nature increases and in inverse, promotes brmhana/samana.

PROPORTION OF INGREDIENTS AND MIXING The atypical use of an emulsion as Vasti dravya needs review and deep study. They seem to act like as a deep cleanser (soap) in a body friendly manner.


An emulsion is



two In

or an


liquids one

which liquid

are (the

normally immiscible (un-blendable).


dispersed phase) is dispersed in the other (the continuous phase). A general guide line is given in the text regarding the proportion of ingredients of a vasti dravya. for a 12 prasruta vasti -Saindhavam-1 part; madhu-16 parts; sneham-24parts; kalkam-8; kashayam-32; parts; aavaapadravyam-16 parts; Total rounded off to 96 parts. Even though the general law of preparing

kashaya is advised for the preparation of same in vasti, we see many modulations depicted as examples. In certain yogas, mamsa is added along with the drugs and reduced to a kwatha (balaguluchyaadi vasti). Whereas in some, kwatha is prepared separately and into it prepared mamsarasa is added (bala patolyaadi kashaya vasti). In some ksheera kashyam is prepared (yashtyhvaadi vasti- AH 5.4.11)) but in some, milk is added to a kwatham and then reduced e.g. rajayaapanam. Relevance of all these need study. TAILAM GHRTAM MADHU Unlike other processes, Vasti have a base of maksikam, lavanam, kalkam and kwadham. It is a conventional practice to add samskruta tailam and ghrtam (but not madhu?) in vasti wherever indicated nonspecifically. It seems that the use of murchita taila/ghrta is enough and logical in kashaya vasti. We dont find many references to add samskruta sneha in kashaya vasti, and not at all of madhu. Samskruta tailam is indicated only in anuvasana. Kashaya vasti contains kashaya yoga and a kalka which are specifically formulated for certain specific condition or purpose. Adding another yoga in the form of taila or ghruta seems to be illogical and unnecessary.(we dont add indukaanta ghrtam and kshirabala tailam

in the place of tailam and ghrtam as ingredients of

chyavanaprasam. And moreover vasti is an emulsion. Purpose of taila and


ghruta are to complement kashaya, which is the major ingredient. If we can add the murchita taila / ghrta, which are made out of the same kashaya yoga of the vasti, it is well and good, but not very practical. KALKAM What is the relevance of kalkam in vasti? It is a vast area for detailed study. Drugs used as kalka have some specialty even though some of them enter into kashaya yoga also. Presumebly due to their bulk nature and fiber content they irritate the intestine for expulsion of the vasti material and fluids, but in a body friendly manner, due to their anti spasmodic property assignable to presence of volatile oils. However, the density of the vasti dravyam is modulated mainly by adding optimum amount of kalkam, although a rough guideline is given as 1/8 of the total quantity. Acaryas have given examples of modulating the action of vasti by only changing kalka. In the base of madhutailika vasti if you replace satapushpa with vacha pippali and madana phala it is called yuktaradha vasti. While adding vacha, satapushpa, hingu, devadaaru and rasna make it doshahara vasti, which is found to be effective in renal failure by the eminent physician Dr.K Rajagopalan. MIXING Over time, emulsions tend to revert to the stable state of the phases comprising the emulsion. Energy input through shaking, stirring, homogenizing, or spraying is needed to form an emulsion. The law of mixing the ingredients in order seems to be based on the consistency/density of the ingredients and their miscibility. Honey is a good emulsifier that stabilizes an emulsion by increasing its kinetic stability. Conventional manual mixing technique may be modified using the simple use


of a mixie/blender. It is very quick, effortless, and highly beneficial in getting a homogeneous emulsion of high quality, which is very tough to get by the manual way. Advantages are -Unparalleled emulsion obtained in hardly one minute. (This is very convenient for hospitals operating many vasti). No need of heating while mixing (it will be sufficiently warm after mixing in it). Mixing order may be followed. Fine pastes can be prepared out easily in chutney jar for kalka; so no need of filtering vasti mixture. Generally, jars can hold sufficient quantity of vasti material. Whether we use manual or machine technique to mix, aim is to get an emulsion of good quality. POSITION OF PATIENT The left lateral position is the ideal one for easy injection and to prevent the damage of rectal valves. FOOD AND VASTI Being an eliminative process kashaya vasti is recommended on empty stomach but before getting hunger. Whereas sneha vasti is recommended immediately after food to get an action in the lower extremity and to induce kapha (kapha dominate post-prandialy) TIME OF ADMINISTRATION Kashayavasti is recommended not in the vaata kaala; because it eliminates kapha and pitta without provoking vaata. So the ideal time for it is fixed in between kapha and pitta kaala. Anuvaasana is generally recommended in the day time but if the condition demands and satisfies, it is recommended in the night also.



SCHEDULE OF VASTI In very chronic conditions, schedule of vasti are recommended in combinations of kashaya vasti and sneha vasti; yoga 8, kaala 15 and karma 30. Conventionally, practice of madhutailika vasti is as per yogavasti schedule with intermittent anuvaasana (=maatravasti?), which is unnecessary and not recommended. To quote ashtanga samgraha kashaya vasti is lekhana and anuvaasana is brumhana by nature. Yapanavasti is a blend of both kashaya vasti and anuvaasana, so there is no need for anuvaasana in-between(AS.4/5/31). This seems to be the reason for blending equal proportion of madhu and tailam, to accomplish the benefits and to ward off the disadvantages from both vasti. DYNAMICS Health is not a static state but a dynamic equipoise. Our body faces many challenges, internal and external. These may be major or minor, like, changes in environment, food, breathing, activities, sleep, hunger, cognition etc. In essence, all these are stimuli faced by the body. Body responds to the essential stimuli and tackles it with or without our will. These stimuli and response are those, which actually sustain us. Health is the ability to withstand or cope up with these stimuli and disease, the inability. Optimum internal and external stimuli bestow wellness. Inconsistent internal and external stimuli trigger illness. Naturally, regulated internal and external stimuli restore healthiness. A working example vomiting as a natural urge or optimum stimulus, act as a health protective mechanism, whereas uncontrolled vomiting, turn out as an illness. Obviously, induced but regulated vomiting or emesis operates as a therapy. A stimulus can be excitatory or inhibitory. This is applicable to vasti also.


The basic principle of treatment in Ayurveda is to assist the body in self healing. Every therapy acts as a stimulus to reveal the healing capabilities of body. Ayurveda aspire that each therapeutic stimulus must, never be contradictory to the complementary factors or they are also considered, and be at the same time specific for a given condition. To be precise, it should be holistic in out look. Regulated stimulation or activation challenges the body in a compatible (body friendly) and condition/tissue specific manner. As a reflex, body responds to this challenge. A positive reflex restores the functional balance (physiology). Samyak lakshana or the success signs of the procedures represent optimum stimulation and optimum response. If continued, they may end up in complications. So every therapy in Ayurveda is a specific regulated stimulation. Specificity with respect to dosha, stage of disease, tissue affected, therapeutic procedure, medicines and many variables need consideration. Koshta (alimentary tract) is the primary site of vital functions like digestion, absorption and defecation, so also of doshas from where they operate chiefly (mukhya sthaanam). For the same reason, the root cause of disease will also be the same site. Purity of koshta is aimed by eliminative therapy; So that the purity of discrete parts (gochara sthaanam) which primarily depend on koshta is achieved. Ayurvedic unique and holistic approach adopts different techniques to help the body system to drain various waste products accumulated in the body thus providing a situation, conducive to the smooth functioning of the life process. Correction of drainage system leads to lack of back pressure from the accumulated waste, which enhances nutrition. ACTION AND OPTIMIZATION Analysis of every therapeutic intervention should be in two angles, since it act in two ways - (1) Action of the procedure per se and (2) Action of the


drugs/medium used for it. Conventionally, the majority have forgotten the procedure as such, which is more important and are behind the drugs, which have, mostly a regulatory/modulatory role on the procedure. ACTION OF THE PROCEDURE Regardless of the drugs used, each procedure has specific function, indication, and contraindication. It is more action specific. As a procedure, basically action of vasti is to regain the Aanulomyam. Vasi is indicated in pathology by pakva dosha operating in pakvasaya (pakvaasaya gata kapha pittam) or from pakvasaya (pakvaasayaat gatam). A local action triggers systemic action through a chain (cascade) reaction. In general, kashaya vasti is indicated wherever the normal order of vaayu is lost due to a local or reactive response of kapha pitta from the pakvaasaya. For ex. Reactive arthritis following an enteric infection (koshta to madhyamaroga maargam). Anuvaasana is specifically indicated in kopa and praatilomyam of vaayu in pakvaasaya associated with severe kapha pitta kshaya (tissue desiccation).

What is meant by Aanulomyam?

Two complementary processes maintain our body, nutrition, and excretion, mediated by the principle of transformation-agni. These two processes are interdependent and the equilibrium maintained with in their limits of fluctuation by the controlling and regulatory phenomenon-vaayu. Any derangement in one will alter the integrity of this complex system. Among the attributes of vaayu, two fundamental ones are dhaatusamyakgati and malapravartanam. Descend down of food from the mouth, its digestion, with assimilation followed by excretion of wastes downwards follows an ante grade movement. This in


Ayurveda parlance is Aanulomyam in the grosser plane. A similar mechanism operates in the subtler level as well. We may identify this as a functional pressure gradient, which facilitates the physiology.

THE OPTIMIZATION ACTION BY THE MEDIUM The medium or drugs regulate or modify the procedure. We are actually inducing certain properties in the organ, which transmit into the body to replicate. They optimize or fine-tune the procedure for a specific condition. The medium optimize the procedure for a specific condition (guna vikalpam). Indication of, padmakaadi and aragvadhadi vasti in conditions of pitta and kapha is an example. It is the tool to bring about tissue/disease/dosha specificity and to make the procedure body friendly e.g. mrdu vasti and tikshna vasti: vrushya vasti, cakshushya vasti etc:. Same drug may act differently in different routes of administration. Amla varga drugs are generally ushna internally and seeta externally. Madanaphala added in vasti is not intending to induce vomiting and it is not acting so. Daamla ksheera indicated internally and externally, but not for the same context or action. The pichila vasti with rakta is not intended for blood transfusion but to induce the pichila guna of rakta by homology, in a condition where there is loss of picha - meaning mucus. Mediums and drugs often does not intend for absorption in vasti therapy. ragvadhdi ganam is having the property of cleansing wounds in both internal and external application; but we cannot prescribe it externally for prameham and chardi. Therefore, we cannot expect all the attributes of a drug to act, when used as vasti. At the same time, few of its actions are common and some are peculiar and cannot occur in the other way.



One therapeutic effect can be accomplished through various modalities and they are not the same in action. So the effect of vasti is not to by pass the oral or any other route of drug administration. It is very specific. To quote an example-the effect chakshushyam can be accomplished by observing daily and seasonal regimes and disciplines, specific food varieties, medicines of wide range, murdha tailam, wearing chapels and using umbrella, ocular therapeutics, specific and general sodhana (virecana, raktamoksha, nasya, and anjana) and specific vasti etc. They act in different planes to accomplish the same purpose according to the given condition. We cannot substitute one for another. Each one has its own limitations and benefits. Administration of vasti seems not on symptomatic basis. It restores the basic physiology (vaatanulomyam) by helping the body to regain a specific and basic operating pathology called vaata praatilomyam. Action and optimization of the procedure and the drugs may correlate to bathing soaps. We have soaps with an array of attributes like moisturizing, scrub, oil control, conditioner, protecting, skin softening, cooling, and with the goodness of fruits, nuts, milk, herbs, vegetables. However, these only modulate the basic purpose of soap i.e. cleansing. Obviously, the additives neither are absorbed nor intend to be absorbed. Vasti as a procedure induces evacuation in the koshta (lower alimentary canal) with an intention of producing a negative pressure. The media used for it regulates and modify the quantity and quality of the evacuation. One of the ingredients of soap is oil but it can be used to remove it; in the same way vasti act. Moisture loss along with cleansing action of soap differs between moisturizing and detergent/oil control soap. This exemplifies the action of various drugs used in vasti. We should not ignore the basic



purpose and action of vasti (aanulomyam) by giving more importance to the drugs used in it. VASTI- DYNAMICS Based on the texts and logic, we may now try to explain, intention of acaryas in formulating the procedure vasti and its mode of action. Through kashaya vasti we are challenging the body with two stimuli; a mechanical stimulus with a bulk of emulsion, and a functional stimulus with a hyper tonic emulsion. The bulk of vasti material distends the intestine and the body by reflex evacuates it, restoring the negative pressure gradient. The second stimulus is a hypertonic solution to which body respond by trying to neutralize it by draining more body fluids towards koshta from the discrete parts. As the permeability of the body is increased with preparatory procedures like sneha sveda, this process is made easy. In this process of washing out of the system, we accomplish elimination of waste products. This will be having a dialysis like action on the whole body. We see an explanation having this idea in carakasamhita and ashtanga samgraham. They say that, by correcting apaana vaayu with vasti, lead to restoration of samaana and consequently regaining physiology of other vaayu also. They in turn regulate all the factors named under pitta and kapha which lead to total restoration of the physiology. And the drugs selected modify the effect and accomplish specificity indirectly. Regarding the significance of drugs in vasti we may think that they act locally on different pathways triggering a cascade of similar response elsewhere in the body, like receptors. As indicated in intricate disease conditions the prescription also cannot be on a oneto-one basis. So the action of vasti is designed with medium that have a collective effect (samudaaya prabhava).



Being an internal stimulus kashaya vasti may cause complications by excess draining of body fluids. To prevent this, an external stimulus to reverse this internal stimulus advised in the form of hot water bath as a post regimen; So that the bodys concentration is reversed from core to periphery. Aim of kashaya vasti is elimination of kapha and pitta without vitiating vayu. Absorption or retention of the emulsion is not its intention (the success signs indicate this), rather its elimination, after a while in a body friendly and tissue specific manner. This action may be correlated to dialysis like toxic radical scavengering. Contrary to this, the demulcent anuvaasana by retaining sneha induces snigdha guna (snehana) locally and body tissues, membranes and glands there and elsewhere regain their tonicity and integrity due to homology. In a dehydrated condition, body responds to a stimulus of retaining sneha by regaining its tone and secretions. When this become optimum the body eliminate it and we see the success signs. Thus, these complementary proceedings regain the homoeostasis. The action of uttaravasti which is also is in the same lines but more specific to a system. Generally, done with sneha preceded by two or three asthapana vastis. From the length of the yantra recommended for uttaravasti, it doesnt seem that the intention is to introduce medicine into the uterus or urinary bladder for absorption. It aims at the restoration of membranes and glands of genito urinary system. PHENOMENAL VASTI FOR THE PHENOMENON VAAYU Even though we can explain the dynamics of vasti based on the present limited knowledge and logics, the ultimate level of action of it and the specific drugs used in it remain phenomenal. No wonder vata being a phenomenon, the ultimate treatment for it, Vasti also remain Phenomenal. But this doesnt prevent us from its deep study of principles and practice, as our seers appeal for


it. We have accepted, based on its effect, even some unconventional vastis like kshaara and vaitharana introduced later by innovators. However vasti should not be degraded to a drug delivery system. We may develop an enteric drug delivery system in Ayurveda but let not name it as vasti. Principles and practice of Vasti is a novel field for detailed study and research, but do it without leaving its Ayurveda spirit.



2. The efficiency of Vasti Karma in every day practice: Expressing the experience

DR. A. S. PRASHANTH, Hubli, Karnataka

Introduction: According to Ayurveda, Vyadhi has been defined as the state in which both the body and mind are subjected to pain and misery. This is the state of imbalance of three Doshas the three basic constituents of the living body. The measures undertaken to restore the Doshika equilibrium is called Chikitsa (Ch. Su. 16/34). The ayurvedic approach to the treatment of a disease comprises of mainly two procedures. 1) Shodhana 2) Shamana Shodhana Chikitsa is supposed to eliminate vitiated Doshas completely and thus prevents the recurring of the diseases. On the other hand Shamana is the conservative treatment as it doesnt eliminate vitiated Dosha but subside them. It is believed that there is no possibility of relapse of the disease cured by Shodhana Chikitsa while the disease cured by Shamana may recur. Panchakarma & Importance of Vasti: The term Panchakarma is frequently used as synonyms of Shodhana. It consists of Vamana, Virechana, Anuvasana Basti, Niruha Basti and Nasya Karma (but it is not only Shodhana Chikitsa) out of the above five Karmas Basti is the most important constituent of the Panchkarma due to its multiple effects. According to Ayurvedic physiology Pitta and


Kapha are dependant on Vata as it governs their functions. Basti eradication morbid Vata from the root along with other Dosha and in addition it gives nutrients to the body tissue (A. S. Su. 28/3). Therefore, Basti therapy covers more than half of the treatment of all the disease (Ch. Si. 1/40), while some authors consider it as the complete remedy for all the ailments. Therefore, Basti is considered the best remedy for morbid Vata, but according to Sushruta, it can also be used in Kaphaja and Pittaja disorders by using different ingredients (Su. Chi. 35/34). Further it has both Samshodhana as well as Samshamana effects also. It performs the functions of restoration of semen, Brimhana in emaciated person, Karshana in obese person, improvement in vision, prevention of aging process improvement in lusture, strength and helpful longevity. Thus, Basti in its different forms has a very wide application. In modern medicine, enema is mainly given to remove the faeces from the large intestine while in Ayurveda, Basti is given as a route of administration of the drugs for multiple action, which acts locally on large intestine as well as systematically on the body tissue. Importance of Vasti: Almost all the Acharyas consider Vasti as the atmost important Karma among all the treatments. This can be understood by the following versus; Upakramaanaam sarveshaam so agranee || (Ash.Hr.Su.19/1) Chikitsaanaam sarveshaam vastih pradhaanatamah || (Arunadatta)



Acharya Vruddha Vagbhata gives a detail explanation for considering Vasti as important one. He tells; Vasti does bring the normalcy of vitiated Vata, brings Brumhana etc effect very quickly without much discomfort, can be indicated to anyone like children, older, lean, obese, debilitated person, women, who is not having children, having less progeny. And it does promote good Agni, Bala, Varna, Medha, Swara, Ayu etc, and can be indicated in Pangu, Rugna, Bhagna, Stabdha, Sankuchita, Adhmana, Shoola, Arochaka, Udavarta and Parikartika etc. (Ash.Sa.Su.28) Acharya Sushruta also gives prime importance to Vasti Karma. He considers Vasti as Pradhanatama karma. He further explains; Vasti does multi-dimensional action by the various combinations used in preparation of Vasti. It helps in the recreation and growth of fresh semen, contributes to the building up and emaciated frame, reduces corpulence, invigorates eyesight, arrests premature, old age and tends to rejuvenate. A regular and proper use of Vasti tends to improve ones complexion and bodily strength, imparts longevity, contributes to the growth of the body, ensures the enjoyment of sound health and guards against the inroad of any disease whatever. To explain how importance Vasti Karma he narrates the following phrases;

Vasti vate ca pitte ca kaphe rakte ca sasyate | Samsarge sannipate ca vastireva hitah sadaa || (Su.Sa.Chi.35/6) Vasti Ardha Chikitsa: Acharya Charaka considers Vasti as half of the treatment in all aspects. He further clarifies that; There is none other than Vayu which is most important causative factor of


diseases in Sakha, Koshta, Marma, Urdhva jatru and Sarvayava angas; and Vayu is only responsible for the Vikshepa and Sanghata of Mala like Vid, Mutra etc Dosha like Pitta etc and all the tissues in the body. So when Vata is getting vitiated severely there is no remedy other than Vasti for its alleviation. Therefore Vasti is considered to be half of all the treatment procedures by the physicians. Some physicians even go to the extent of suggesting that Vasti represents the whole of the therapeutic measures. (Cha.Sa.Si.1/38-40) Acharya Vagbhata (Ash.Hr.Su.19/85-86) as well as Acharya Sushruta (Su.Sa.Chi.35/29-31) also opines the same as above.

EFFECT OF BASTI: It acts on various disorders because of the selection of the drug according to disease. (Charaka.) Curative. (Charaka) Uncomplicated. (Charaka) Basti can be administered at any age and at any stage of disorder after proper examination. It also can be given in normal persons too. (Charaka) A) Promotive Aspects : Sustains Age. Provides better life, improves strength, digestive Power, voice and complexion. Perform all functions. Provide firmness. Corpulence quality.


Lightness in viscera / systems because removal of morbid body. Restores normalcy . Increases Relish. B) Curative Aspect : Relieves Stiffness. Relieves contractions and adhesions. Effective in paralytic conditions. Effective in dislocation and fracture conditions.

matter from all over the

Effective in those conditions where vata aggravated in Shakha/extremities. Relieves pain. Effective in disorders of GI tract. Effective in diseases of Shakha and Kostha. Effective in the diseases of vital parts, upper extremities and Localized or General part. Beneficial to debilitated and weak persons. Arrest premature old age and the progress of C) Preventive Aspects : Beneficial in constipation. Effective to purify various systems of the body. D) Rejuvinative Aspect : Increases the quantity and quality of sperm. Effective to restore the normal functions of blood and other Dhatu. It provides strength by increasing muscle power. Beneficial as geriatrics.

white hair.


E) Effect On Brain And Psychology : Provides clarity of mind. Induces sound sleep. Lightness. Exhilaration. Invigorates eyesight. Spright lightness of mind.

F) Effective At Any Age And In Any Season : Basti is non antagonistic to healthy, diseased and old persons. Applicable in all seasons. Basti can be administered in child and older person too. Because it is free from complications.

Various Basti in common Clinical Practice: Madhu Tailika Vasti Erandamooladi Kashaya Vasti Vaitarana Vasti Lekhana Vasti


Kshara Vasti Ksheera Vasti Vrushya Vasti Yapana Vasti Piccha Vasti Sangrahi Vasti Takra Vasti




DR. MAHESH, Kerala

Ayurvedic physicians are familiar with the word vyapath, whenever they read about treatment procedures, especially Panchakarma. The word vyapath defined as Apatthi, Sankata, Vyadhi, Vikriti, Vikara in Samhitas, refers to any problem or disease that occurs during/subsequent to any treatment procedure. It may not be termed as adverse effect, rather a complication arising out of a faulty treatment, which may be minute or gross; simple or complex. Our Acharyas had keen observation and were able to identify many reasons for these vyapaths in various Ayurvedic procedures. In the contex of Vasti, Charaka had listed 44 vyapaths, while Sushruta narrated 76. Besides, Charaka has mentioned many other vyapaths here and there, during the narration of different vastis. While going through these explanations, we understand that the root cause is not properly following the guidence of the text and mere observance of the rules will prevent a majority of vyapaths. Domine of such rules starts right from the selection of the patient for treatment, till the end of parihaara kaala(the period of restrictions).

These vyapaths can be classified in various ways: Based on causative person1. Vaidyanimitta 2. Preshyanimitta 3. Baishajyanimitta 4. Aturanimitta


Based on causative factor1. Netradosha 2. Putakadosha 3. Dravyadosha 4. Shayyadosha 5. Pranidhanadosha 6. Peedanadosha 7. Miscellaneous Based on the type of vasti1. Niroohajanya 2. Anuvasanajanya 3. Uttaravastijanya Based on gravity of symptoms1. Mild 2. Moderate 3. Severe Based on duration1. Immediate 2. Short term 3. Long term Based on appearance of symptoms1. Local 2. Systemic Based on time of occurance1. During introduction 2. Before evacuation 3. After evacuation NETRAJANYA VYAPATH: Physician shall owe responsibility for these vyapaths. They are due to vastinetras which compromise with the prescribed qualities. Previously metallic netras were in use; nowadays, are being substituted with plastic netras or enema nozzles. In some



places, rubber catheters are also used. The material, agewise length, size of the opening, length of insertion told in the texts are very important in the procedure Prevention- Follow the rules while selecting proper metallic/plastic vastinetra or enema nozzle. Plastic netras should be checked for rough/sharp edges especially. Better to use enema set in patients having haemorrhoids, fistula, fissure etc. Use of catheters may be good here. PUTAKAJANYA VYAPATH: In olden days, different animal bladders were used as vastiputakas. Now, thick plastic covers(preferably double layered) or enema cans are being used for niroha and syringes are used for anuvasana. Prevention- Proper dimensions of Cover/apparatus/syringe are to be ensured. Leakages, if any, checked priorly. Tying of the cover/fitting the apparatus should be proper to prevent leakage and air bubbles. SHAYYADOSHAJANYA VYAPATH: In the history of medicine, explanations regarding practice of vasti for various purposes is available, in the West, till the early part of 20 th century. Various positions were used to introduce vasti then. They might have run from the days of Sushruta, as he had pointed different positions, other than the classical, may lead to vyapaths. Prevention- Following the classical left lateral position with left hand below the head, left leg extended & right leg flexed, on a horizontal cot. If it is inevitable to give vasti in other positions, physician must be ready to counter the consequences. PRANETRDOSHA JANYA VYAPATH: Caused by the fault of the person who administers the vasti. His experience, observation, knowledge of anatomy all count here. He should have kind heart, know technique of introducing vastinetra, exerting proper pressure over putaka and console the patient. The pressure to be exerted will be different for nirooha & anuvasana. Prevention- Teach basic things to the attendent, give vasti in the presence of physician PEEDANADOSHAJANYA VYAPATH: These occur due to faulty pressure over the putaka or improper height of enema can. Kinking of the tube and entry of air bubbles will also cause irregular flow.


Prevention- The pressure over the vastiputaka should be steady. When enema set is used, required height is mantained. 30 matra peedanakala shall be maintained as far as possible. Completely emptying the putaka is to be avoided. DRAVYADOSHAJANYA VYAPATH: These are due to fault of physician to formulate apt vasti for the patient. Prevention- Follow the directions in the text for formulating or mixing the dravyas properly. In case of doubts, discuss with experienced physicians SNEHAVASTI VYAPATH: These are due to fault of both vaidya & atura, because of misjudging or not following regimes during snehavasti. Prevention- Educate the patient properly. A close watch on the patient is necessary ATURANIMITTA VYAPATH: These are exclusively due to fault of rogi to follow physicians directions towards ahara & vihara during the vastikarma, including parihara kala Prevention- These must be avoided as far as possible by taking the patients into confidence. They must be well educated about the procedure as well as importance of regimes during that period. VAIDYANIMITTA VYAPATH: These are very important and cause severe complications, even lead to death of the patient. These are due to physicians inexperience, lack of knowledge or judgement error. Prevention- Keep in touch with the text regularly. Discuss with experienced physicians. Evaluate the experiences of colleagues. MISCELLANEOUS VYAPATHS: There are some other vyapaths seen nowadays, other than those mentioned in texts. Unhygienic drugs- Raw & prepared drugs collected unhygienically may cause complications. Use of gomootra & milkis also questionable today in veiw of Leptospirosis like diseases



Adulteration of drugs- Many of the raw drugs are substituted with unknown adulterants, which may cause severe ill-effects Nosocomial infections- Unhygienic atmosphere & vessels may be sources of dreadful infections at hospitals today, viz. HIV, HbsAg. Use of same vastinetra without proper sterilization may become a medium for their spreading. Severe UTI is commonly seen after uttaravasti Prevention- Know the source & collection methods of the raw drugs. Use drugs prepared by reputed manufacturers. Maintain hygiene as much as possible. Do necessary investigations to the patients before procedure. DETAILS OF SOME COMMONLY SEEN VYAPATHS Vyapath Pain, Reason Dosha Sharp/rough/longer vastinetra Shaking netra while introducing Twisting netra inside anal canal Repeated entry of netra tips Treatment of Wash water/ kashaya Apply Jatyadi taila or Shatadhouta with cold triphala

burning, Injury

bleeding at anal area

ghrita pichu Avagaha in sheeta kashaya Panchavalkala picchavasti of

Pain, burning & Delayed entry discomfort abdomen of

Minute/sideward opening (catheter) Less force

Abhyanga, swedana, massage Anulomana shoolaghna oushadhas like locally &

Air entry

Repeated pressing of putaka


Completely emptying of putaka Not removing air bubbles before introduction Vatapittakopa Rooksha, nirooha Vatakopa Improper snehana & swedana sandra,

ashtachoorna/ hinguvachadi choorna/ vaishwanara choorna

teekshna with anupana Udavartahara chikitsa Anuvasana ksheerabala



/Madhuyashtyadi taila Pain discomfort bladder area & Injury in bladder area to Upward introduction of netra Teekshna, lavanadhya nirooha Improper snehana & swedana Abhyanga, swedana locally Anulomaka, mootrala ahara Anuvasana mridu sneha Delayed entry Blockade Less force Improper introduction Minute opening Sandra vastidravya Less pressure/ insufficient height Not passing stools before vasti Quick evacuation Vasti entering not Not voiding urges before vasti Incontinence of anal sphincter Introduce properly with

after passing stools Provide needed

pressure/ height Use netra with larger opening Calm patient & console




Ushna, teekshna, lavana vasti in Another mridu koshta Given in wrong positions Fear & tension Improper introduction of netra given



Select suitable vasti Proper positioning of netra

Delayed evacuation


Mridu, sandra, sheeta, alavana Abhyanga nirooha


swedana to abdomen

Less amount of anuvasana in Teekshna nirooha kroorakoshta Improper snehana & swedana Vibandha, shoola, adhmana Sit in toilet & keep the water tap on &

Vata & kapha Mridu, sheeta, alavana, rooksha, Abhyanga vriddhi sandra nirooha Excess quantity of sneha Divaswapna after anuvasana Teekshna nirooha Improper snehana & swedana

swedana to abdomen Anulomana teekshna oushadha &



Pores in putaka/enema can Loose fitting of netra/syringe Improperly entered enema

Properly done again with material suitable

nozzle/catheter/syringe/vastinetra Less amount Small putaka/can Wrong calculation Quick evacuation


Reasons told above



Vatapittakopa causes dhatukshaya, kampa, weakness, diarrhoea, gudabhramsha etc.

Teekshna, ushna, excess quantity Stambhana treatment of vasti in mridukoshta & Picchavasti Refer controlled if not


Angamarda, cramps, stiffness

Vatavriddhi Vatavrita sneha

Sheeta, less quantity of sneha in Vataghna oushadha, vatolbanavastha Improper snehana & swedana Alpa bala nirooha Vatakara ahara & vihara abhyanga, swedana, teekshna & ushna vasti Follow strictly Abhyanga, swedana, anuvasana regimes

Low back ache


Prolonged sitting, exercise Vatala ahara

Vomitting giddiness

& oordhwaprapti

Excess force used Given in head down position Given when hungry

Sprinkle cold water over face Massage downwards Anulomana

Given after food

oushadha Treatment for chardi Refer if not cured

Chills, sheetajwara


Sheeta vasti given in samavastha Exposure to cold after vasti

Abhyanga swedana snana

& Ushnajala



Ushna & jwaraghna oushadha Daha, bhrama, moorcha jwara, Pittavriddhi Ushna, teekshna, lavanadhya Sprinkle cold water Drakshadi kashaya

vasti in pittakopa Exposure to sun

Kamadugha rasa Avipathy choorna Ksheera bhojana Ksheeravasti

Jwara, gourava, Amavriddhi klama, pratishyaya

Apakwa oushadha Atisnigdha & sheeta vasti Sneha vasti after heavy food

Langhana, Pachana, Rooshana, Swedana Jwaraghna oushadha Teekshna vasti

Divaswapna after anuvasana Mridu nirooha in amavastha Shwasa, hrillasa Vatakapha vriddhi Ajeerna Agnimandya Mridu, sheeta, snigdha vasti in Shwasaghna kaphadhikya Heavy procedure Divaswapna after anuvasana Pravahika Vata kaphakopa leads to meals during chikitsa, anulomana the Follow srictly Pachanoushadha regimes

& Mridu & alpoushadha vasti in Peyadi krama bahudosha Vilwadi vati Kutajarishta Picchavasti

frequent urges with quantity stools


less of with




kaphasrava & weakness Parikartika Cutting pain in Teekshna, sacral, inguinal, umbilical, anal & bladder area along vibandha frequent passage stools Headache, indriyadourbalya Overstrain Prolonged TV watching, talking, Strictly reading regime Take rest follow of with & vasti in atilavana, rooksha Anulomanoushadha & Mridu anuvasana Ksheeravasti Picchavasti



SOME DRUGS REQUIRED TO TREAT VYAPATHS: Choorna- Vaishwanara, Hinguvachadi, Hingwashtaka, Shankha Bhasma, Triphala Vati- Bilwadi, Agnitundi, Mrityunjaya Rasa, Shankhavati, Kamadugha Rasa, Dhanwantara, Gorochanadi, Chandraprabha, Yogaraja Guggulu Arishta- Mustarishta, Amritarishta, Pippalyasava, Kutajarishta, Draksharishta, Jeerakarishta Lehya- Bilwadi, Dashamoola Hareetaki, Sukumara Rasayana, Shatavari Guda Taila- Ksheerabala, Madhuyashtyadi, Dhanwantara, Kottamchukkadi, Jatyadi KashayaGandharvahastadi, Chirabilwadi, Mustakaranjadi, Drakshadi, Amritottara,

Punarnavadi, Triphala, Dashamoola



Vasti- Dashamoola Nirooha, Picchavasti, Ksheeravasti, Vaitarana Vasti, Ksharavasti, Madhutailika Vasti GENERAL PREVENTIVE METHODS: Follow the guidelines of acharyas for treating a patient with vasti. Some of the points to be remembered are: Check whether the disease is vastisadhya Examine the patient for assessing bala (physical & psychological) Assess the suitability of doshavastha for snehavasti/nirooha Consider the Desha, Kala, Agni, Koshta & Satmya for selection of drugs Decide the quantity & netra according to vayas Ensure genuinity of raw & prepared drugs; hygienically collect fresh milk, gomootra etc. Educate the patient clearly about the procedure & regimes to be followed Explain the possible complications to the party & take informed consent Keep the drugs to treat vyappaths ready at hand Well equipped treatment room with attached toilet(commode) & hot water facility Keep the instruments ready after sterilization-Single use vastinetra/enema set is better Ensure patient is neither hungry nor in full stomach for nirooha & arrange suitable food Mix vastidravya properly & filter the mixture to remove solid particles Heat suitably over vapours & keep it filled in vastiyantra After abhyanga & swedana to whole body, lie the patient down in proper position Put handgloves ; annoint netra & guda with snigdha dravya Do P/R examination & introduce netra in proper direction & length Press the putaka steadily with a little amount left behind, when patient counts till 30 Slowly remove netra and dispose hygienically; ask patient to lie in supine position and console Advise to evacuate when urge occurs & not to lock the door Observe for Suniroodha lakshanas; another vasti may be given if required Ask to take food soon after hot water bath Walk a few steps and lie in left lateral position without sleep For anuvasana, add shatahwa & saindhava choorna to prescribed sneha and mix


Heat suitably over vapours & fill in vastiputaka/enema syringe Take prescibed food in proper quantity after abhyanga, swedana & hot water bath Ask to void urges if any & introduce vasti in proper position Take supine position and make prescibed movements Get up and walk a few steps & rest without sleep Ask to inform the time and nature of evacuation & observe samyak lakshanas Plan the next vasti, if any Vasti is one of the popular & highly effective Panchakarma treatment which can be administered without much restrictions of age, sex, bala etc. But, negligence towards the procedure may induce grave vyapaths and tarnish the reputation of the physician, hospital & finally, of Ayurveda. Therefore, it is our duty to gain proper knowledge in advance and try to prevent them at the earliest.




Dr. Madhava Diggavi, Bellary, Karnataka

sarvam cha roga prashamanaya si. 1/59. Every effort of clinician is to produce positive relief & recovery in symptoms from the suffering ailments. Yat yougikam bheshajam tat samyak prayuktam siddyatiti siddantaha. cp. Ca. Si 1/59 If a consultant physician exclusively design a medicine as per the clinical requirement &then perfectly plan the intervention &administer the respective drug as per norms then only clinical breakthrough or success is possible. Uttarabasti means trans urogenital drug administration modality. the aim is to give relief to the sufferers sufferings by specified SOP of uttarabasti. Ativruddhe anile na adau sashtam snehanam brumhanam. ca. si 1/57-58. Vasti upakarma is a broad spectrum therapeutic modality for vata dosha & vata vyadhi. vasti chikitsa incorporates all the three of niruha anuvasana & uttarabasti(AH SU). After the clinical diagnosis of ati pravrudha vata dosha initially snehana & brumhana should not be initiated. Haste is waste. Shula supti angamarda may denote involvement of vata dosha. But medakapha avagruheeta vata dosha should not be underestimated by illogical vatavyadhi practice. Mere vatahara oushada is not enough to treat VATA DOSHA & Vatavyadhi ca si1/58cp. Raktadi dhatu sandooshita/sammurchita vata & margavarana must be specified before the commencement of vataupakarma ca si 1/58cp. Dosha dhatwantara saapeksha bheshaja & upakarma are better practiced in vatavyadhi ca si 1/58cp. So it infers that uttarabasti upakarma should be practiced by targeting margavarana, Dhatu sandooshana, dhatu sammurchana &dosha dhatwantara sapeksha etc. if the above data is available to the vasti practitioner then that becomes emperial approach.



Sammakshya, gnanapurvakarmavekshya, doshadeenvekshya prayukta basti siddyanthi. cp casi3/6. Perfect thought, knowledge ligated discussion & impinged dosha pareekshaneeyas are incredible markers of success for vasti/ uttarabasti.

Bahuroga hita basti pratipadanam. ca si 10/1 cp. Basti is an intervention of choice in innumerable number of diseases. It also implies that uttarabasti is also logically applicable in innumerable clinical condition wiz analgesic nephropathy, ACKD, PKD, HTN, CRF, DMnephropathy, FSGS, PSGN

ALPORTSYNDROME, Nephrocalcinosis, defective spermatogenesis, erectile dysfunction, male & female infertility, BNO, obstructive uropathy neurogenic bladder dysfunction, chronic cystitis, BPH, ashermans syndrome(adhesion), endometrial hyperplasia, fallopian tube dysfunctions, chronic cervititis, chronic vaginitis, dysparaunia ,pyronies disease, urolithiasis etc., Upakramanam agrini trividhastu saha. AHSU 19/1, ca si. 10/8. Vasti upakarma is top end modality amongst various theraperetic procedures; & vasti upakarma is a total package of three procedures wiz anuvasana niruha & uttarabasti.

Uttaranam sreshtanam bastinam siddhihi uttarabasti AHSU 19/1, ca si. 10/8. Uttarabasti is superior & best among top end treatment modalities called vasti upakarmas. Means vasti is best among panchakarma procedures & uttarabasti is best of bests among vasti procedure. Vajikaranam.............madhughruta payo yuktaha....... ca si 10/13. If vasti/ uttarabasti are administered with honey+ghee+milk, then it serves as vajeekaranam i.e. it stimulates reproductive hypo endocrine axis and sex- neuropeptide chemistry. Mahadoshakarani ashtani imani......kshayaja vyadhayah.......maithunena kshayaja. ca si 12/12 After samshodana upakarma if one commits mistake of performing shouting or sexual coitus (eight mahadoshakara bhava) etc., then various syndromes take their respective origin. Interesting to note that in uttaravasti sidhi chapter, charaka samhita deals with 8 precipitating


factors and manifestations along with management. Post shodhana sexual indulgence leads to various urogenital & other systematic problems, the management of same is done with extremely good niruha-anuvasana/uttarabastis.hence the chapter is called uttaravastisiddhi .even though kashaya & ksheerapaka are used in uttarabasti, the post uttarabasti schedule is as that of anuvasana/snohopakarma. Ubhyatharakara....naranarinam sarvarogaprashamanaha... sukra mamsa bala pradaha... apatyapradaha|ca si 12/22. Yapana vasti explained in uttarabastisidhi chapter is denoted for its dual action. In the sense it is detoxifying as well as pacifying. Dual action also denotes per rectal as well as transurogenital drug delivery system. Chatu sneha anuvasana/uttaravasti ca si12/18-1. Intended to be rasayana effective in nasta retas, anartava, &mutra apathy snehavasti/ uttaravasti of ca si12/19 possesses rasayana effect even when sneha used is prepared by one time cooking (paka). If the same taila/sneha is prepared by shatapaka/sahastrapakamethod then the drug becomes more effective. Specially to promote virya(beeja) and bala(pourusha or vyadhi kshamatva) sahacharadi anuvasana can also be used in uttara basti for women(lalita) and queens (anta pura vasiniee) ca si12/18-3. Three vrushyatama rasayana sneha yogas explained ca si12/19 is targeted on urogenital & neuro endocrinal endpoints it is told that three snehas can be used for snehabasti upakarma it can be concluded that the snehas vide above are useful in uttarabasti of male &female. Post samshodana sexuality ca si12/13-8 et al, leads to physical, psychological, psychiatric, neuroendocrinal, reproductive, excretory, urogenital, musculoskeletal, cardio respiratory, thyroimmune & even ophthalmic presentations. To manage the same yapana/ vrushya and equally uttarabasti are explained. Kevalavate vatolbaneshu dosheshu vaa rajonashe ashmari ruksha srotasi..... Mutra Bhagamargena naranarishu niruhaanuvasanayapanatwenopi diyate sa uttatrabasti. ca si 12/8, ah su19/29 Bastigathe doshe mutramargagate yonigarbashayeshu cha. Srutha dosheshu mutrashayagatheshu tu vidadhayat basti uttaram. Uttarabasti is administered after asthapana shudhi, basti putaka of smaller size (50ml syringe practically), basti netra of 12 angula to 14 angula (4 to6mm sterile rubber catheter) are the instruments required for uttarabasti. Sterile oil is a must uttarabasti. It can be intravesical, intrapenile, intracervical, transfundal, transtubal, intraveginal as the case may be. Niruha uttarabasti, yapana uttara basti, sneha


uttarabasti are administered either in paired (yugma) or ayugma (unpaired) schedule as per clinical requirement. Uttaravasti is choice of treatment in nirupastambhitavata, vatapradhanatridoshaja vyadhi, bastigatadosha, mutrashayagatavata, artava dosha, mutramargaga vyadhi, yonivyapat,



pakwashayagatavata, artavavaha

koshtagatavata, srotovikara,




shukravahasrotovikara, rajonasha, anartava, klaibya, vandhya etc...

UTTARABASTI INSTRUMENTATION ENGNEERING: In male uttarabasti netra may be considered 12 angula(ah) 14 angul(SU). The opening of which may be of mudga diameter or siddarthakas diameter. It should be soft and malleable, made up of gold, silver or currently rubber catheter also. Vasti putaka can be animal bladder/rubber pouch of capacity of 1 prakuncha, 1 pala, 50 ml to 250 ml. 50 ml dispovan or 100ml. Syringe is used practically. Practically 30 to 40 ml of snehana uttara basti and 125 to 150 ml of yapana/ niruha uttarabasti are enough. In female, 10 angula netra for garbashaya vikaras Trans cervically with opening of mudga pramana. 4 angula netra in apathy marga trans vaginally. Intravescically 2 angula netra and in adolescents 1 angula netra is useful. Vasti putaka varies from quantum of 2 to 10 ml size, for intra cervical sneha uttarbasti. Intra vaginal putaka, Capacity can be up to 20 ml, and intravescical up to 80 ml. HSG cannula intra cervical uttara basti is a good instrument 10 ml dispovan good in case of intravaginal instruments. UTTARAVASTI SCHEDULE (MALE): Patient is treated with pachana, deepana, rukshna, snehana, swedana, vamana, virechana as the case may be.later uttaravasti can be started in two ways. One is after pratyagamana of niruha/yapana/ksheeravasti by rectal route, patient should relax, take bath, after the lunch, transpenile/transvescicle uttaravasti is administered. In other way, after the completion of yogavasti (3 niruha and 5 anuvasana) uttaravasti is administered for 3days. Three days of niruhavasti is given and on 4th day uttaravasti is administered vangasena et al.


After the completion of virechana and samsarjanakrama, anuvasana uttaravasti and niruha uttaravasti are administered in yugma yogavasti schedule. Followed by sadyovirechana/ koshtashuddhi, only anuvasana uttaravasti is administered for 3days and after a gap of 3days again repeated for 3days. Sterile goksheera, ksheerapaka, saghrita ksheerapaka can also be administered in yapanavasti schedule also. UTTARAVASTI SCHEDULE (FEMALE): After regular investigations and after 5days of menstrual cycle patient is subjected to pachana,deepana, snehapana, swedana, vamana/virechana procedures carried out in the same or next cycle in-between 5th and 15th day. In next consecutive cycle yugma yoga basti in yapana basti is carried out& at the end 3 days of intra cervical uttara basti is administered. In other way from the day 6, three days of trans rectal niruha basti and after the prathygamana of the same transcervical anuvasana uttara basti can be administered.3 days of intra-cervical anuvasana uttara basti or snigdha shodana uttara basti can be administered from the 9 th day of cycle.intra vaginal yoni puranavat anuvasana uttara basti can be administered from day 9 or12 for three days. Intra-cervical uttarabasti procedure is simplified by fallowing new hsg technique.intra-vaginal niruha basti vaginal doushe type and intracervical anuvasana uttarabasti can be administered alternately in yoga basti schedule from day6. UTTARA BASTI PROCEDURE (MALE) Patient is posted for uttara between 11 am to 3 pm, after intake of comfortable food, patient is subjected to pubic shave and after passing stools and urine patient is taken into minor OT and given supine posture. the required instruments wiz, artery forceps, 6mm rubber catheter, green towels, towel clips, green gown, cotton swabs and utter basti medicaments in a conical flask are autoclaved. Pubic area is painted with beatdine and the glans pennies is cleaned with sevlon and covered with green towel with central hole patient eyes is covered with cotton swab.50 ml sterile dispovan is filled with required amount of sterile uttara basti medicaments and sterile catheter is connected to the seringe, air bubbles are removed the tip of the catheter is immersed in sterile oil or ghee. With the sterile gloved hand the pennies is cusped and with the right hand tip of the catheter is placed into the urethral opening and gradually slowly passed into the pennies. While passing the catheter slowly the contents are pushed, when inhibition is felt to the tip of the catheter at external


urethral sphincter gentle pressure is applied and catheter is made to enter into the urinary bladder. The patient feels bit pain at this time which is tolerable and subsides later. Now thaw catheter stays inside the bladder and doesnt slip out. This can be guided by Trans pubic ultra zoography also. Now the contents of the syringe are slowly passed into the bladder without any enter of air bubble. Then catheter is slowly withdrawn from the tract but doesnt require any pressure and even catheter comes on its own. In other way, firstly bladder is catheterised and urine is drained into a kidney tray, then to the catheter in situ syringe loaded with sterile content is pushed into bladder and then catheter removed. After the removal of catheter, gentle anticlockwise massage over pubic area, abdomen, flanks, medial part of thighs and low back area. Patient is advised rest relaxation and deep breath. Patient should follow snehavastis post operative care. should not consume liquids up to two hours. When patient gets maturation reflex, is advised to urinate in a container and observed for pratyagamana of medicament, and patient can drink plenty of day course is repeated. UTTARAVASTI PROCEDURE (FEMALE) As per the clinical requirement indifferent methods are to be adopted. Just similar to hsg, intra cervical uttara basti can be done. in another way in lithotomic position on minor OT, under aseptic precautions, after uterine sound holding the cervix a catheter is passed into the cervix and the medicine about 5 to 10 ml is passed inside. In case of intravaginal uttarabasti,after vaginal douche, a sterile 5 ml dispovan is inserted and content are pushed into vagina and a thick cotton swab is kept at vulva.then patient is advised to rest in supine position.



UTTARABASTI PHARMACOLOGY The gamitva of the drug used for uttarabasti is guided by affinity uptake entry at the level of receptors channel. The drug has affinity to the concerned dhatu, it has action on srotas and it is carried to the site of action. Administered drug interacts locally and sends afferent signals to master organ the brain. the material used for uttarabasti possesses both rasapradhana(ahara)and virya pradana(oushada)dravya, which augments with respective active receptor under the signals of brain and hence shows its effect via route of administration as well as pharmacology upon disease and DDM(doshadhatumala) Sammurchana ca vi 1/9. Route of drug administration based on rasa dosha prabhava (RDP) through various inherent and modified properties of the drug wiz dhatu veerye prabhava etc undergoes various bio enzymatic pathways along the srotas and therefore active molecular concentration if the end product at target tissues rises. Lastly at the expected kalaa effect is executed and action on DDM samurcchana and aneka doshatmaka diseases is exhibited. Anuvasana and niruhabasti perrectally or intra vescicaly in alternate paised from alternate membrane PH anuvasana ends to rise in PH acidic ally and niruha leads to increased alkalinity. So the net potential generated helps in Trans membranal drug activity under the influence of governing brain enzymes. Every induced action wiz uttaravasti has respective signal transformation in brain and neuroendocrine metabolic pathway. So the rocket phenomena of uttarabasti therapeutic procedure or drug delivery system neuro endocrinaly brain designs respective effective enzymes and target then a target cell. If the right stimulation with correct amount of drug energy is induced in the body then is brain minds, then only positive corrective energy is released to pacify the problem and promote urogenital procreative or recreative activities. S. BAGEWADIKAR et al Diet or drug based formulation intravescically in adequate quantity in its active form(RDP), reach entire body in general and site of action in particular, to release active molecule. Mechanical stimulation, receptor initiative or negative pressure feedback etc work here. Achieving and maintaining concentration levels for desired period of time alters the


rasadi dhatwagni vyapara and in the functional unit the action is initiated. The energy required to suppress or alter the pathological state of metabolism and brains enzymatic reactions at optimum way is going to work. Intravescical pressure and coronary artery pathology are pathophysiologicaly relative to each other. Mutra/pureesha vegadharana has negative impact on hrudaya ahsu 4 etal. Cardio renal, hepato cardio renal axis and hepato renal dysfunction is observed in various multi organ failure cases 0f renal, adrenal, vesicle, and testicular pressure are maintained by liver. Every organ and cell requires certain pressure to work at physiological limit, the change in pressure of the liver due to any CNS signal alteration, leads to genitor urinary dysfunction. Uttarabasti of various schedules definitely works on the pressure gradient when sufficient thermal heat is produced and good circulation is maintained. Keen observation of uttarabasti as a whole implies that the mode of action is multifaceted and multifocal. S. Bagewadikar etal it is a best programmed engineering between brain and urogenital and metabolic programmes. the energy is realised by uttarabasti decides the signal transmission, pressure gradient, thermal heat and command by brain to change to charge the spermatozoa, stimulate cogenesis, active nitric oxide pathway and venous pooling at corpora are synchronously planned orchestra. Nutrition and supplementation is also a way of correcting the pathway. DATA ANALYSIS (UB MALE) 1. Kseerabala taila uttara basti testicular rejuvinative and promotes spermatogenesis 2. Shatapaka bala taila enhances sperm count. 3. Dashamula taila helps in kaphaja sukra dusti, high viscous semen, antisperm antibodies,epididymitis maturation arrest up to primary spermatid level

atherosclerotic disorder of penile artery,arteriogenic erectile dysfunction, etc 4. Amrutadya taila helpful in neurogenic bladder, bladder neck obstruction, BPH, defective spermatogenesis, antisperm antibodies, testicular rejuvenation, scrotal vericocele,erectile dysfunction oligoastenoteratozoospermia. 5. balashatavari kseerapaka increases sperm count and sexual desire. 6. Yastikseerapaka increases semen volume and repeted erections. 7. Sariva kseera decreses puscells burning sensation, uretritis,

in semen(payobacterosperma), decreses postact


8. Balamula ashwaganda kseera with ashwagandadi yamakam increases the penile hardness, increases penile/pelvic thrusts, increases semen volume and decreses semen liquification time, effe3ctive in shukrataralalyam. 9. Vastyamayantaka ghruta is helpful in chromic cystitis, vesicle calculus , ureteric spasms, increased bladder wall thickening, increases residual volume BPH seminiferous vascicsulitis obstructive azoospermia 10. mahamasha taila increases sperm count , increases sperm RLPmotality, increases semen volume, and effective in penile arousal time. DATA ANALYSIS (UB FEMALE) 1. Dashapaka bala taila intra vaginally and intra cervically effective in cervical factor and endometrial thickness promotion and increases fecundity rate. 2. Dashamula taila intra cervically helps in tubal factor , endometriosis, endocervicitis, chromic vaginitis, trichomanas vaginalis stimulates follicular pickup from fimbrial end, PCOD. 3. Madhuyasti taila effective in cervical erosion. 4. Apamarga kshara taila helps in partial tubal blocks, tubal irregularity. 5. amruta asvatha kseera augments pregnancy rate. 6. Panchavalkala kwatha intravaginal niruha uttara basti is effective in vaginal

candidiasis, leucorrhoea. Cervicitis and cervical factor. 7. Phala sarpis help in ovulatory dysfunctions. 8. Shata paka bala taila is helpful in hypo plastic uterus. 9. Panchatikta kashaya intra vaginal niruha uttara basti and pancha tikta ghrutha intra cervical anuvasana uttara basti is effective in dysmenorrhoea sub mural fibroids. 10. Indukanta ghrutha dashamula kseera yapana uttarabasti kastarthava and irregular cycles. is effective in fibroids ,




Dr. A K Manoj Kumar, Kottakkal

Vasti is the most important procedure among Panchakarma. It is considered as the ardhachikitsa of Ayurveda. To achieve the said effect it has to be executed properly. Along with the procedure pre and post operative measures are also equally important. Materials required Makshika, Saindhava, Taila, Kalka, Kwatha, Vastinetra, Vasthiputaka (plastic bag), Thread, Cotton, Gloves, Vessels, Mortar, Pestle, Hot water etc are the minimum materials required for Nirooha. Preparation of medicine Makshika, Lavan, Sneha, Kalka and Kwatha are the recommended order of adding the ingredients for mixing. But in practice lavana is added before makshika. It enhances proper mixing as the quantity of lavana is very little. Take powdered saindhava in the mortar. Then makshika is added to powdered saidhava little by little and triturate well. When these are properly mixed, add taila in small doses and mix it thoroughly so that no oil floats on it. Then add kalka little by little and mix it well. Pour kwatha slowly and mix it thoroughly to form a well consistent mixture. The mixture usually appears like an emulsion. Hence, follow the principles of emulsion making in mixing the Vasti Dravya. A very good association of oil and water is seen in vasti dravya. Always mix in the clockwise direction to achieve a strong association of oil in water. It is true that a few vasti dravya looks like solution or colloid too. It is quite natural to have some drug particles enter in the large intestine through the vasti dravya. Usually it comes from Kalka. Any gross particles in the mucosa cause irritation. As a result intestinal motility and bowel frequency increases. Hence the vasti dravya may be filtered properly to prevent drug particles from entering the lumen. Then warm the mixture by keeping over steam. Sterilize the vastinetra and close the tip with a cotton wick. Pour the


mixture into the vastiputaka, insert the vastinetra into it and tie properly with the thread at the bottom in between the two karnika. Lubricate the upper end of vastinetra well with oil. Preparation of Patient Fitness of the patient is most important. Few deaths observed after nirooha was because of cardiac involvement. Hence, it is better to avoid vasti in patients with severe cardiac lesions. E C G and ECHO screening is advisable before vasti. A per rectal examination is mandatory to rule out space occupying lesions and bleeding spots in rectum. Informed consent should be obtained from the patient after making proper education about the procedure. Patient intended for nirooha should undergo the purificatory procedures like snehapana, svedana, sodhana and anuvasana. On the day of nirooha patient can have light breakfast. One or two pieces of bread/idly/dosha along with a cup of milk or tea at about 7 - 8 AM are sufficient. This is to prevent complications by avoiding excess appetite at the time of vasti. Usually nirooha is done at 10.30 - 11.30 Am. The patient is subjected to Abhyanga and svedana, especially on the belly of the abdomen, low back region and lower loins just before performing niroha. The anal canal has to be properly lubricated by applying oil. Procedure Moderate appetite is essential at the time of nirooha. Remove the cotton piece from the tip of vastinetra and let out the air bubbles trapped in the vastinetra by squeezing the bladder and close the tip of vasti netra with the tip of index finger. Patient should be in the left lateral position with no pillow. He was asked not to shake his body while taking the basti. Gradualy introduce the vastinetra into the anus parallel to the vertebral column without making injury to anal canal. Squeeze the bladder slowly and uniformly so that the mixture enters into the colon. Mean while ask the patient to breath through the mouth. Keeping a little medicine in the bladder, retrieve the vastiyantra gently from the anus. Let the patient lie supine with a pillow expecting the Vega. He should evacuate the bowel as he feels so. Analyse the samyak nirooha lakshana immediately. An orderly



evacuation of Mala, Pitta, Kapha and Vyu is expected. Instead, if the patient evacuates the medicine alone, another vasti should be administered. Then he should take bath in hot water. Soon after bath boiled rice with soup should be taken. Favourite side dishes, not against the disease condition will enhance the food intake. Absolute bed rest with peace in mind is mandatory in nirooha. Research Safety and Efficacy of the individual ingredients as well as the procedure itself is needed for the propagation of nirooha. Recently W H O has documented and prepared a guideline for vasti through AYUSH. All aspects included in the draft should be validated by following rigid methods in research. Before validation each ingredients of the vasti should be standardized. Clinical validation should be carried out for different combinations in different disease conditions. Erandamooladi Nirooha vasti is lekhana in action and has a wide range of indications. It has to be validated for establishing the specific indications in specific disease conditions. Likewise all combinations of nirooha should be studied for establishing the specific area of action. Different institutions are using different methods for mixing vasti dravya. They include khalwa, mixer grinder, homogenizer etc. The rationality of mixing techniques should also be standardized. The mixture should be analysed in terms of the parameters laid down for solution, emulsion, colloid etc. The order of adding the ingredients, the speed and time of mixing etc should be standardized. Instrument standardization is another area of research in nirooha. The difference between enema can and vasti yantra is debated across the country since years. The truth is not yet been established properly. The pressure and time of pressing the vasti putaka is to be analysed in different combinations. Different types of complications are observed in nirooha. Their reasons and solutions should also be studied. Most advanced research methodologies may be sought for research in vasti. Chemical Finger printing and particle size analysis of vasti dravya are essential. Methodological issues are another big area of concern. Randomization, masking, controls, placebos etc have to be


discussed in detail. Implementation of recent research guidelines of I C MR like Black Box Designs etc should be explored. Conclusion A scientifically designed and well executed nirooha will work beyond our imagination. The protocol has to be validated by incorporating very rigorous research methodologies. Bibliography 1.Ashtnga Hridaya by- Kaviraj Atridev Gupt, Chaukhambh Sanskrit Sansthn Vrnasi. 13th Edition, 2000. 2. Ashtnga Samgraha wih Sashilekh Tka, by- Dr. Jyotirmitra Acrya, Edited by- Dr. Shivprasad Sharma, Chaukhambh Sanskrit Series Office Vrnasi, 2008. 3. Caraka Samhit Part 1-by Shree Satyanryaa Shshtri, Chaukhambh Bhrti akdmi, 2001. 4. Caraka Samhit Part 2- Pndt. Kshinth Shshtri & Dr. Gorakhanath Chaturvedi, Chaukhambh Bhrtiakdmi, 2004. 5. Caraka Samhit with Ayurveda Dpika Tka- by Vaidya Ydavaji Trikmji Acrya, Chaukhambh Surbhrti Prakan Vrnasi, 2008. 6. Kshypa Samhit (Vrudha Jvakya Tantram) Chaukhambh Publications by Pandit Hemarja Sarm. 7. Sushruta Samhit First Part by- Anantram Sarm, Chaukhambh Surbhrti Prakan Vrnasi, 2008 (Ni. Sthna 5/14) 8. Guidelines on Basic Training and Safety in Panchakarma, AYUSH, 2008 9. Practical Handbook of Panchakarma Procedures,C C R A S, 2009 10. Guidelines for Clinical Research Methodology in Ayurveda, M S Baghel, 2011



Abstracts of Oral Presentations



1. Basti- Yantra An Innovative Approach Dr. Arvind Kadus

Abstract. Introduction:- In ancient time; Basti putak was made up of Basti i.e. Bladder of various animals and Basti netra by various metals. It was a difficult job to prepare Bastiputak without any defect. As Acharyas were aware of these defects of Bastiputak and Bastinetra; 8 types of faults / defects had been described. Contents:- Now a days patients are ready to undergo Basti Chikitsa, but they are aware of sterilisation, cleanliness of instrument etc. So by using new technology; new disposable Basti-Yantra ( Basti Pouch ) has been innovated. This Basti-Yantra is very easy and convenient for use. The photographs of new Basti-Yantra, its merits, the procedure of administration of Anuvasan Basti by our Basti-Yantra will be illustrated in our full paper. Key words:- Basti- Yantra, Bastiputak, Bastinetra. ======================================================= Dr. Arvind Kadus

Proprietor, Agasti Pharmaceuticals, Pune.



2. Hypothetical Evaluation of action of Basti karma - A literary review

Dr. Deepa Patil*Dr. Vijay Dandavatimath MD (Ayu) ** Abstract The Basti karma is most important therapy in Pancha Karma, with wide scope of applicability; and said to be special treatment for Vata. It has effects of purification, pacification, rejuvenation etc. So it has got utmost importance in Pancha karma procedures and is said to be Ardha or sampurna chikista. Colon hydrotherapy or colon cleansing is a flushing of an old toxic waste in the large intestine with warm and chilled filtered waters alternatively - a safe, re-energizing, restorative non-medical procedure. A "colonic" cleansing is one of most effective ways to get rid of toxic accumulations of bodily waste (which can build up over years), excess mucus, toxic compounds, and gas. It also helps restore colon muscle tone, rebalances intestinal flora, and improves overall health. Improving one's system of elimination removes the body's primary source of disease. So a hypothetical attempt is made to discuss the action of Basti karma with the help of colon hydrotherapy parallely. Key words - Basti karma, Ardha or Sampurna Chikista, Colon hydrotherapy ========================================================= * 1st year PG Scholar, Department of Panchakarma ** Lecturer, Department of Panchakarma KLE Universitys Shri B. M. Kankanawadi Ayurved Mahavidyalaya, Shahapur, Belgaum



Dr.Poorvi.Athreya*, Dr.Vijaykumar.Dandavatimath** ABSTRACT

Nirooha basti is a commonly prescribed and aministered panchakarma procedure regularly in general practices. The efficacy of this procedure specifically is attributed by influence of host of confounding factors, main and other adjuvant panchakarma procedures. An observational study was taken up in KLE Universitys Sri BMK Ayurved Hospital on patients administered with kostha shodhana , as in sadyovirechana prior to nirooha basti specifically ErandaMoola nirooha basti. A parallel observation was made on patients who were given niroohabasti without administering kostha shodhana instead other panchakarma modalities, as in sarvanga abhyanga, udwartana, jambeerapatra sweda etc were done. Interpretation and analysis were done based on the symptomatic relief, samyak nirooha lakshana and regression in the severity of the disease condition. It was noted nirooha basti administered with prior kostha shodhana significantly improved the condition of patients, providing immediate relief. Keywords Niroohabasti, koshta shodana, bastikarma,shodhana

=============================================== *Post Graduate scholar,Department of Panchakarma, KLE Universitys Sri BMK AyurvedMahavidyalaya, Shahpur, Belgaum **Lecturer,Department of Panchakarma,KLE Universitys Sri BMK AyurvedMahavidyalaya,Shahpur,Belgaum



4. Evaluation of electrolytes following basti therapy DR.Prathibha Puranika K * Dr.Shailesh M D* Dr.M S Kamath**, Abstract. Back ground: Basthi has got an important role in panchakarma therapy and is indicated for the treatment of various diseases. Many conventional medical practioners feel that these basti of Ayurvedic Science may result in Electrolyte imbalance and harm people. However there are no studies co-relating effects on electrolytes available.Keeping this in view this study was planned to evaluate electrolytes in patients undergoing basti therapy. Objectives: To evaluate serum electrolyte before and after Ayurvedic basti therapies in clinical practice Method and material: This is a non-randomized uncontrolled open clinical study conducted in one month duration with lateral sample technique method and on small sample size of 8 patients. Individuals undergoing yoga basti in the panchakarma therapy center of Ayurveda department of Kasturba hospital were selected for the study after taking oral consent from each patient.A pre treatment serum electrolyte is obtained before starting basti. The same was repeated after completion of 8 days of basti. Vital signs, the total quality of basti administered every day, time of administration of basti and time of evacuation of basti were properly recorded



on a day to day basis. Standard students T test was used to find the statistical correlation using SSPS statistical software.

Inclusion criteria: Individuals willing to undergo study. Individuals fit for yoga basti according to Ayurvedic science. Individuals (male or female) above 18 yrs and less than 70 yrs. Individuals who were not suffering from pre existing electrolyte imbalance or fluid imbalance.

Results: Though small in sample size ,this study has clearly showed us that, basthi do not produce any clinical or biochemical electrolyte imbalance. Conclusions: Basti can be administered safely in day today practice,in all type of indicated conditions and all different patients. Keywords:Basti therapy, electrolytes, analysis.

Additional Professor &Head, Dept.of Ayurveda, KMC, Manipal



5. A CLINICAL EVALUATION OF YASTHIMADHU SADHITA KSHEERA BASTI IN MANAGEMENT OF SANDHIVATA (OSTEOARTHRITIS) Dr Sangeeta Dhar*,Dr Harsha S G *Dr K. J. Malagi**, Abstract. Sandhivata in one of the commonest disease observed in vatavyadhi in the modern day scenario1. Osteoarthritis also known as degenerative arthritis is a progressive disorder of the joints caused by gradual loss of cartilage and resulting in development of bony spur and cyst at the margin of the joint .An attempt has been made to evaluate the efficacy of yasti madhu sadhita ksheer basti in the management of sandhivata . 40 patients suffering from sandhivata were selected irrespective of sex, cast, creed, religion. A special Performa was made to evaluate the effect of yasthi madhusadhita ksheera basti in sandhivata.

The results are encouraging in pain modulation, range of motion and quality of work.

The details have been explained in detail in full paper.

KEY WORDS: Sandhivata, Yasthimadhu sadhita ksheer basti, Pain modulation, Range of motion.



6. The Comparative Clinical Study of two Basti Yoga on Gridhrasi.

Shweta.A.H*, Zenica Dsouza** Abstract. Gridhrasi is Rujapradhan Vatavyadhi, intervening with the functional ability of low back and lower limbs causing hindrance in routine life. Basti is considered as one of the important treatment for Vatavyadhi which is having multidimensional action by its virtue. Our Achryas mentioned specific treatments for Gridhrasi like Siravyadha, Basti and Agnikarma. All the three treatments have good effect on disease but Siravyadha and Agnikarma are used in specific conditions only and having complications. Basti helps in radical cure of Gridhrasi in various conditions and safe therapy.This paper is a humble attempt to present a clinical study conducted on Erandamooladi and Vrushadi Niruha Basti in patients suffering from Gridhrasi and probable mode of action. Erandamooladi Niruha Basti is explained in Charaka Siddhisthana 3/37, is indicated for Gridhrasi, the yoga is having mainly Vata-Kapha Shamaka property. Vrushadi Niruha Basti is also indicated in Gridhrasi and explained is Sushruta Chikitsa 3 8/67-70.

*3rd year PG Scholar, Dept of Panchkarma, AAMC.Moodbidri. ** HOD Dept of Kayachikitsa, AAMC.Moodbidri.



7. Effect of Matra basti in Neurological deficit as Consequence of Compression fracture of Lumber vertebra (L2) - A case Study
Dr. Nagasri N. Ekbote*Dr. R. V. Sanapeti ABSTRACT Lumbar compression fractures can be a devastating injury. The fracture itself can cause significant pain, and sometimes does not resolve, can alter the mechanics of the posture. In older patients, such fractures usually occur in the absence of trauma or in the context of minor trauma, such as a fall. Such trauma-related fractures cause severe pain in the back and may cause numbness in these areas if fracture injures a nerve in the spine. A male patient aged 75 years with complaints of severe back pain radiating to both lower limbs associated with numbness and with history of compression fracture of L2 vertebra approached our hospital. He was unable to sit for 3 minutes and walk 25 steps. On examination it revealed nerve compression. The clinical symptoms resembled that of Vataja Gridhrasi. The line of treatment adopted here was Matrabasti with Dhanwantaram taila along with different Upakarma measures which gave remarkable results symptomatically and the same is discussed in the paper. Key words - Compression fracture, Matra basti, Vataja gridhrasi * 1st year PG Scholar, Department of Panchakarma. **Lecturer, Department of Panchakarma KLE Universitys Shri B. M. Kankanawadi Ayurved Mahavidyalaya, Shahapur, Belgaum
M.D. (Ayu)


( Email:


8. ROLE OF MAJJA TAILA BASTI IN LUMBAR CANAL STENOSIS A CASE STUDY Dr. Nitin B. Patil.*Dr. Sunil S. Inamdar** Abstract Musculoskeletal disorders are among the leading cause of disability and absenteeism from work. The person who suffers from this disease is particularly handicapped, as he cant walk, stand or sit properly and painful limbs continuously draw his attention. The modern management for this condition is either conservation like rest, immobilization, analgesic and anti-inflammatory drugs, physiotherapy etc. Or in severe cases surgical. Even surgery is also not ultimate solution, as post surgical reoccurrence of common problem decreases patients working capacity. In Ayurveda it comes under one of the type of Vata Vyadhi, representing with ruja, toda, stambaha, Suptata etc. and can be treated with following proper Chikitsa Krama explained in classics. Basti is the main line of treatment for Vata Vyadhi as well as good for pitta and kapha doshas. A case reported to Sukhayu Ayurveda Panchakarma Kendra with pain in lower lumbar region radiating to B/L lower legs with numbness and difficulty in walking for long distance, getting up from sitting posture. Through investigation diagnosed as Lumbar canal Stenosis. During hospitalisation patient underwent various Panchakarma procedures like Abhyanga, Swedana, Kati basti, lepa etc but significant relief got after doing treatment with Majja Taila Basti. Details of which will be discussed in full text. Key Words : Lumbar Canal Vyadhi,Musculoskeletal Disorders.






PG Scholar, Department of Agada Tantra, Shri. BMK Ayurvedic Mahavidyalaya, Shahapur, Belgaum-03, Karnataka.

Dr. Sunil S. Inamdar, MD (Ayu), Sukhayu Ayurvedic Panchakarma Kendra, 8 lane Rajarampuri, Kolhapur, Maharashtra.



9. ACTION OF MATRABASTI IN DUCHENNE MUSCULAR DYSTROPHY W.S.R. TO MAMSAVRITA VAATA- A CASE STUDY *Dr.Savita. S.Butali**Dr.Aziz Arbar Abstract The most severe form of muscular dystrophy, DMD usually affects young boys and causes progressive muscle weakness, usually beginning in the legs. DMD is a recessive X-linked form of muscular dystrophy, which results in muscle degeneration, difficulty walking, breathing, and death. Duchenne muscular dystrophy (DMD) is the most common muscular dystrophy affecting 1 in 3500 boys born worldwide. There is no specific cure in any system of medicine and the death usually occurs before the age of 20 years caused by respiratory failure or less frequently by cardiac involvement.. A male child aged about 12 years, approached our hospital. It was a diagnosed case of duchenne muscular dystrophy. Matra basti promotes strength and without calling for any strict regimen of diet. It performs the function of Brimhana. Basti is the best method of treatment for Vaatadosha. The case was treated with Matrabasti. It gave encouraging results. The same principle is discussed in the paper

*PG Scholar(Deptartment of Kaumarabhritya) **Lecturer (Department of Kaumarabhritya), KLEUs Shri BMK Ayurveda Mahavidyalaya Belgaum



10. A COMPARATIVE CLINICAL STUDY TO EVALUATE THE EFFECT OF UTTARA BASTI AND MATRABASTI IN KLAIBYA W.S.R TO ERECTILE DYSFUNCTION *Dr. Mahesh Sharma.M ABSTRACT: Klaibya is a vikara of Jnanendriya. karmendriya, with the involvement of Mana and Vata Dosha, Sukraksaya in particular, ** Dr.Gajanana Hegde


Sukravahasrotodusti and Mana Dosha are the prime factors involved in the pathogenesis. And it very well co-relates with that of erectile dysfunction. E.D is a multifactorial condition commonly observed in the society. According to the survey conducted by India Today the prevalence of the disease is one in every ten is Impotent in India. Master and Johnson also reported a fear of impotence in all men above 40 years of age. Considering the grave nature of the disease with its higher incidence, it has been selected for the present study to find out a better cure. As Basti is very much highlighted and praised in the context of Klaibya to overcome the aggravated vata, in the present study Basti is selected in the form of Matra Basti and Uttara Basti owing to their devoid of code of conduct of Niruha Basti. So that one can perform routine activities without interruption. The objective of this present study was to evaluate the effect of Ashwagandha taila in Klaibya and to compare the efficacy of routes of drug administration.



Methods Study design A Comparative Clinical Study. Intervention Total 29 patients were selected incidentally and assigned into two groups consisting 15 patients in Group A and 14 in group B. Group A patients received Ashwagandha taila uttara basti (30ml) and group B received Ashwagandha taila matra basti (60ml) Results Effect of both the procedures with Ashwagandha taila showed highly significant results in parameters such as penile erection rigidity and ejaculation, Patients of group B expressed greater benefit compared to group A. Where as in group A patients statistically significant results were observed in orgasm and performance anxiety. Keywords: E.D, Klaibya, Uttara Basti, Matra Basti, Ashwagandha taila

*Pg Scholar Final year, Dept.of Kayachikitsa, G.A.M. C, Mysore, Karnataka. ** Head of department, Dept.of Kayachikitsa, G.A.M. C, Mysore, Karnataka.



11. TO EVALUATE THE EFFICACY OF TRISHATI PRASARANI TAILA MATRA BASTI IN JANU SANDHIGATA VATA WITH SPECIAL REFERENCE TO OSTEOARTHRITIS OF KNEE JOINT A CONTROLLED STUDY Dr.Manjunathkanthi* Dr.Ravindra G S2*, Dr.Shylajakumari3* ABSTRACT Osteoarthritis is by far the most common form of arthritis. It shows a strong association with aging and is a major cause of pain and disability in the elderly. SandhigataVata is grouped under NanatmajaVataVyadhis. Dhatukshaya which is a part of aging process is the main causative factor for this clinical entity. Basti is the best modality of treatment for Vata diseases and Taila is the best Vatahara drug. MatraBasti can be administered to people of all age in all seasons without strict restrictions of diet and regimen. Chakradatta claims that TrishatiPrasaranitaila relieves the stiffness and restores normal movement of the joints, and has indicated it especially in JanuSandhigataVata. Objectives of the study: 1) To evaluate the efficacy of TrishatiPrasaraniTailaMatraBastiin the management of JanuSandhigataVata. 2) To evaluate the efficacy of ShodhitaTilaTailaMatraBasti in the management of JanuSandhigataVata. 3) To study the comparative efficacy of the

TrishatiPrasaraniTailaMatraBastiand ShodhitaTilaTailaMatraBasti in the management of JanuSandhigataVata.



Study design: 30 patients of JanuSandhigataVata were randomly recruited to 2 groups. The group A patients received 2 courses of MatraBasti with TrishatiPrasaraniTaila while Group B patients received 2 courses of MatraBasti with ShodhitaTilaTaila. Index of severity of Osteoarthritis of the Knee by Lequesne et al. was taken as subjective parameter. Tenderness, Crepitus, Knee circumference, Range of movement of Knee and time taken to walk 50 meters distance, were taken as objective parameters. In Group A out of 15 patients, 7 patients (46.67%) showed marked improvement, 5 patients (33.33%) showed moderate improvement, 2 patients (13.33%) showed mild improvement, and only one patient registered no change. In Group B out of 15 patients, 2 patients (13.33%) showed marked improvement, 3 patients (20%) showed moderate improvement, 6 patients (40%) showed mild improvement, and a total of 4 patients (24.67%) registered no change Key Words:SandhigataVata, MatraBasti, Prasarani, DhatuKshaya.


Corresponding Author PG Scholar,Dept Of PG Studies in Panchakarma, Govt. Ayurvedic Medical College, Bangalore,Karnataka,India.
2 3

Lecturar, KPSVS Ayurvedic Medical College Manvi, Karnataka.

MD (Ayu), Professor, Dept Of PG Studies in Panchakarma, Govt. Ayurvedic Medical College, Bangalore,Karnataka,India.



12. EVALUATION OF KSHEERA BASTI AND MATRA BASTI IN GRIDHRASI - A COMPARATIVE CLINICAL STUDY Dr. Mukund Karhade * Dr. Salma Shirin 2*, Dr. Shridhara B S3* Dr. R. Shylaja Kumari4* ABSTRACT Gridharsi is enumerated one among the Vata nanatmaja and samanyaja Vata vikaras. It is correlated with disease Sciatica in modern parlance. Most commonly encountered factors for the disease are bad posture, irregular and unwholesome dietary habits, travelling in jerky vehicles etc. It is having a prevalence of 40 % in the population the impact of which is staggering on society. In spite of tremendous advancements in field of modern medicine, the management of Sciatica in contemporary science is still limited and has a less favourable outcome and consumes more health resources. The Ayurvedic classics deal the disease with various therapeutic measures, amongst which Basti therapy was taken for Clinical trial. The therapeutic effect of Matra Basti in Gridhrasi is known by various studies conducted so far. So in this study Ksheera Basti was taken to evaluate the efficacy of Ksheera Basti in comparison of Matra Basti. OBJECTIVES 1) To evalvate the effect of Matrabasti in Gridhrasi. 2) To evalvate the effect of ksheerabasti in Gridhrasi. 3) To compare the effect of ksheerbasti and Matrabasti in Gridhrasi.



METHODS It is a comparative clinical study. In this, 30 patients were taken for the study and divided into two different groups of 15 patients in each. The subjective and objective parameters were observed before, after treatment and after follow up and were recorded in the case Proforma of Gridhrasi. Group A treated by Ksheera Basti Group B - treated by Matra Basti RESULTS Effect of Ksheera Basti: In group A, 8 patients (53.33%) showed marked improvement, 4 patients (26.66%) showed moderate improvement, 3 patients ( 20 %) showed mild improvement. Effect of Matra Basti: Group B showed marked improvement in 6 patients (40 %), moderate improvement in 3 patients (20%) and mild improvement in 4 patients ( 26.66%) and no relief in 2 patients (13.33%). Comparison of the effects of Ksheera Basti and Matra Basti Ksheera Basti showed better results in the parameters Right SLR test, Right and left lateral flexion, and Extension whereas Matra Basti was better in parameters Pain, Forward flexion, Left SLR test and Rotation.



CONCLUSION Statically the overall response of the treatment was significant in both the groups. There was no significant difference seen across the two groups. Key words: Gridhrasi, Matra Basti, Ksheera Basti

1* Corresponding Author PG Scholar, Dept Of PG Studies in Panchakarma, Govt. Ayurvedic Medical College, Bangalore, Karnataka,India. 2* Lecturar, KPSVS Ayurvedic Medical College Manvi, Karnataka. 3*MD (Ayu), Professor, Dept Of PG Studies in Kayachikitsa, Govt. Ayurvedic Medical College, Bangalore,Karnataka,India. 4* MD (Ayu), Professor, Dept Of PG Studies in Roganidana, Govt. Ayurvedic Medical College, Bangalore,Karnataka,India.




Abstract.The 21st century with its continuous changing life styles, environment and dietary habits have made man the victim of many diseases. Obesity is one of them. Obesity is a disease which affects ones social, physical and mental features. As per new researches, it is a precursor to coronary heart disease, high blood pressure, diabetes mellitus and osteoarthritis which have been recognized as the leading killer disease of the millennium. Hyperlipidemia is one of the major health issue in present scenario. Lipid and lipoprotein abnormality are extremely prevalent now a days due to changed life style. Hyperlipidemia is one of a modifiable risk factor for atherosclerosis and coronary heart diseases. In Ayurveda there is no direct references of obesity and hyperlipidemia are available but may be related with Sthoulya, Medovridhi, Santarapanjanya Vyadhi. For Present study the drug chosen for this procedure is mainly Lekhaneeya mahakashaya mentioned by Acharya Charaka. The Protocol consists of 16 basti out of which 10 Sneha basti and 06 Kashaya basti. 18 patients of either sex are taken for the study and the protocol has significant effect in reducing body weight, S Cholesterol, S Triglyceride, S LDL, S VLDL. Details will be discussed in full paper. Keywords: Obesity, Hyperlipidemia, Lekhaneeya Mahakashaya, Kala Basti * PG Scholar, **HOD & Associate Professor, ***Assistant Professor Department of Panchakarma, Government Ayurveda College, Tripunithura, Ernakulam, Kerala, India. Mob no. 09037743943



14. TO EVALUATE THE EFFICACY OF VAITARANA BASTI IN AMAVATA- A CONTROL STUDY Dr.Shridharlakkundi* Dr.PreetiPathak2*, Dr.Shridhara B S3* ABSTRACT Amavata, is the most common joint disorder worldwide. It has already been proved that the Panchakarmas are beneficial in managing the

Amavata,Bastikarma is the most important amongst the Panchakarmas. Incompatible food habits sedentary life style and undesired exercise are the common factor producing global health problem AMAVATA. In

Amavataenormous previous work has been done, here an attempt is made to implement different methods of administration of VaitaranaBasti with control group. The objectives of the study are vaitaranabasti in amavata. 2) To evaluate the effects of vaitaranabasti without anuvasanabasti in amavata. 3) To evaluate the effects of luke warm water enema in amavata. The study is a controlled clinical trial in a three groups of 15 patients each, where two group patients received Vaitaranabasti with murchitatilatailaAnuvasana or without Anuvasana& 3rd Group received Luke warm water enema. Subjective parameters are the chief complaints of Amavata. And objective parameters are Hb%, E.S.R, warmth , redness etc. Assessments are done before and after the treatment. At the end of treatment there was significant change in Shoola, Shotha, Stabdata,etc in group A compared to group B & C showing the P value < 0.001. This signifies that yoga basti group in turn plays vital role in correcting pathology of the disease and gives remarkable results.

1)To evaluate the effects of


Ingredients of Vaitaranabasti possess properties such as Vedanashamaka, ShotaharaLekhana and also Vatanulomaka. There by, it is an ideal treatment of choice in Amavata. Key words :Vaitaranabasti, Amavata,Erandataila, Ajamodadichurna, yoga basti, marked, moderate and unchanged.

Corresponding Author PG Scholar,Dept Of PG Studies in Panchakarma, Govt. Ayurvedic Medical College, Bangalore,Karnataka,India.
2 3

Lecturar, KPSVS Ayurvedic Medical College Manvi, Karnataka.

MD (Ayu), Professor, Dept Of PG Studies in Kayachikitsa, Govt. Ayurvedic Medical College, Bangalore,Karnataka,India.



15. Lekhana basti in Sthoulya A critical analysis

* Dr. Shubha Rani.M ABSTRACT: Wherever is the carcass there will be vultures gathered together" in the similar fashion, the Obesity (Sthoulya) is such a physical state where Hypertension, Osteoarthritis, Diabetes Mellitus, Cardio Vascular accidents, impotency and many other grave complications are the Vultures invited. According to Acharya Dalhana in Sthoulya, excessive nourishment is received and with a good Jatharagni excessive poshaka Anna rasa is formed which have madhura Snigdha Guna pradhanta so due to specific Dhatu poshakamsha only Meda Dhatu is produced in excessive quantity and quality. In Charaka Samhita most of the qualities of Tikta Rasa has been described which are very suitable for the management of Sthoulya. Lekhana Basti is the other and most important Karma which has been mentioned by all Acharyas for the management of Santarpanotha Vyadhi, Kaphaja Roga and Kaphavrita Vata [Cha.Si.3, Su.Chi. 38, Sa. 6/23] Sthaulya is one among them. "Lekhanam Karshanam" (Su. Su. 40/5 Dal.) Thus Lekhana is nothing but a process of emaciation while Sharangadhara considered lekhana in a wide sense i.e. lekhana is a process of drying up or desiccation of all excess Dosha, Dhatu and Mala i.e. "Deha Vishosanam " (BP. Pu. 6/224) "Dhatun - Malan va Dehsya Vishoshya Lekhayechha yat lekhanam" (Sha. Pu. 4/10). That means the drug which rarifies the protoplasmic contents of tissue cells and thus gradually clears the system of its deranged constituents is known as lekhana. Basti not only have localized action, but the active principles of Basti drugs are absorbed and reaches through channels of the body at the site of lesion ** Dr. Gajanana Hegde



and bring about systemic action hence administration of Lekhana Basti checks the dushti of Rasa, Meda and Kapha. KEY WORDS: Sthoulya, Obesity, Lekhana basti

*Pg Scholar Final year, Dept.of Kayachikitsa, G.A.M. C, Mysore, Karnataka. ** Head of department, Dept.of Kayachikitsa, G.A.M. C, Mysore, Karnataka.



16. Action of Ksheerabasti in Avascular necrosis of head of femur w.s.r. to Asthimajjagata vata- A case study
Dr. Suma S. S. Joshi*Dr. Rajashekhar V. Sanpet MD (Ayu) ** AbstractAvascular Necrosis (AVN) is the death of bone tissue due to a lack of blood supply. It is also called osteonecrosis, bone infarction, aseptic necrosis and ischemic bone necrosis. Avascular necrosis of the femoral head is an increasingly common cause of musculoskeletal disability, and it poses a major diagnostic and therapeutic challenge. Although patients are initially asymptomatic, avascular necrosis of the femoral head usually progresses to joint destruction, requiring total hip replacement (THR). A male patient, aged 62 years, approached our hospital with complaints of pain in left hip joint, which was aggravating on movement. Patient had restricted movements and swelling in both feet. It was a diagnosed case of avascular necrosis of head of femur of Grade IV. The clinical symptoms were similar to that of Asthi-majjagat vata. Ksheerabasti is the line of treatment for Asthi-majjagat vata. The same line of treatment in this case for seven days gave a marked improvement and is discussed in the paper Keywords: Avascular necrosis of head of femur, Ksheerabasti, Ashti-majjagata vata

*PG Scholar, Deptartment of Panchakarma ** Lecturer, Department of Panchakarma. KLE Universitys Shri B. M. Kankanawadi Ayurved Mahavidyalaya, Shahapur, Belgaum


17. A COMPARATIVE STUDY ON TWO DIFFERENT METHODS OF ADMINISTRATION OF MATRA BASTI IN JANUSANDHIGATA VATA W.S.R TO OSTEOARTHRITIS OF KNEE JOINT. Dr.Vanishree J M1* Dr.SumitR.Patil2, Dr. Pushpalatha3 Abstract: Osteoarthritis is a Degenerative joint disorder characterized by

breakdown of joint cartilage. According to WHO Osteoarthritis is the 2nd commonest problem in the world population i.e 30%, Age, female sex, obesity, occupational Knee bending, making it an important cause of disability. Here study on matrabasti was conducted in two groups A was increasing dose and B was fix dose matrabasti with panchatiktasadhitksheersarpi for nine days. Term matrabasti signifies the dose of sneha used for basti. Aadhamalla explained the dosage of matrabasti for 9 days in arohanakrama by increasing 6ml every day from 24ml to 72ml. Vangasena, chakradatta opines the same.

Panchatiktaksheersarpi is used in basti for 9 days after abhyang and ushnajalasnana and food. 30 patients were divided in two groups randomly. Diagnosis made on X-ray knee joint and classical symptoms. Differences between Tenderness, Crepitation, Joint measurement and Goniometric examination was assessed on 0th, 9th and 27th days with Wilcoxons signed rank test for within group change and Mann Whitney test for between group change. By comparing the overall responses it can be concluded that GroupA patients responded better than the GroupB patients for the treatment.



Keywords: - Osteoarthritis, Matrabasti , Knee Joint.


Corresponding Author PG Scholar,Dept Of PG Studies in Panchakarma, Govt. Ayurvedic Medical College, Bangalore,Karnataka,India.
2 3

Lecturar Dr J. J. MagdumAyurved College Jaysingpur Maharashtra India.

MD (Ayu), Professor, Dept of Sharirakriya, Govt. Ayurvedic Medical College, Bangalore,Karnataka,India.



18. UTILITY OF BASTI KARMA IN VATAJA DISORDERS MANOJ KUMAR* DR. SRIPATHI ACHARYA** ABSTRACT:Basti karma is a specialized procedure which has its own importance in the management of diseases by Ayurveda. Specially vataja disorders can be better treated by usage of Basti chikitsa. By this procedure we are administering the medicine through Ano-rectal opening. Ayurveda considers basti chikitsa as one of the main important treatment for vata dosha. Vataja disorders like pakshaghat, adharanga vata , gridhrasi, sandhigata vata, katishoola, and amavata are few diseases which can be effectively managed by basti chikitsa. Matra basti with saindhawadi taila, anuvasana basti with balaguduchyadi taila, and yaapana basti are the commonly used bastis in the management of vataja disorder. Basti causes malavata anulomana as well as shodhana of vata.Since pakvaasaya is the main seat of vata , basti being acting upon pakvaasaya expels out unwanted vata effectively. Some of the drugs used in anuvaasana basti are having actions like snehana, brmhana, rasaayana, malavatanulomana etc.. The present paper highlights utility of disorders. *Student ,3rd BAMS. ** Dept of KAYACHIKITSA ,MIAMS,MANIPAL Basti Karma in different vataja



Dr.RashmiRao* Dr.Sandeep M 2, Dr.Janaki Y S3

With the march of time, most of the dietary habits (virrudhahara), social structure, life style, and environment have been changing. Occurrence of vatarakta is also one of the outcomes of thesemodifications.Based on the signs and symptoms, this vatarakta can be compared with GoutyArthritis of contemporary medicine. It has a strong affinity to affect the joints and causes work disability. It is said that there is no better treatment than compared to Ksheerabastiin the management of Vataraktaas it removes the doshas along with the mala from the moola.

1) To evaluate the efficacy of Aushadha siddha Ksheerabasti in the management of Vatarakta. 2) To evaluate the efficacy of Plain Ksheerabasti in the management of Vatarakta.3)To compare the efficacy of Aushadha siddha Ksheerabasti with Plain Ksheerabasti in Vatarakta. Study design: It is a comparative clinical study, where in 30 patients were randomly divided into 2 groups Group A & Group B. The diagnosis was made based on the signs & symptoms of Vatarakta& raised Serm uric acid level. Patients of Group Ai.e Trial group received Aushadha siddha Ksheerabasti& patients of Group B i.e Standard group received Plain Ksheerabasti. To study the incidence a survey was conducted among the patients visiting the male & female OPD of S.J.I.I.M Hospital Bangalore during 2008-09. In group A 2 patients showed Mild improvement (13.33%), 7 patients showed Moderate improvement (46.67%),& 6 patients showed Marked improvement (40%). In group B 2 patients showed No improvement(13.33%), 6 patients showed Mild Improvement(40%),5 patients showed Moderate Improvement(40%) & 2 patients showed Marked Improvement
Key Words:Vatarakta,GoutyArtritisYashtimadhuksheerapaka,Guduchigritha,Ksheerabasti.


Corresponding Author PG Scholar,Dept Of PG Studies in Panchakarma, Govt. Ayurvedic Medical College, Bangalore,Karnataka,India. 2 LecturarAtreyaAyurvedic Medical College Doddaballapur, Bangalore 3 MD (Ayu),Asst. Professor, Dept Of PG Studies in Panchakarma, Govt. Ayurvedic Medical College, Bangalore,Karnataka,India.



20.Importance of Therapeutic & Pharmacological considerations of Basti karma in current Practice.

Swapna Gunjal Prasanna Aithal** Vasant Patil***

Basti Karma is well known therapeutic procedure in Panchakarma due to its extensive applicablity and strength to control Vata Dosha. In Ayurveda it is considered as Ardhachikitsa because of its incredible actions in most of the diseases. The selection of Basti is an important step which depends upon several factors mainly Roga and Rogi. The essential therapeutic considerations of Basti are examination of Dosha, Aushada, Desha, Kala, Satmya, Agni, Satva, Vaya and Bala in a patient for aciehving desired effects. The Basti Dravya is a combinations of various drugs which depends upon the therapeutic effect as Shodhana, Shamana and alike. The volume, Ph, temperature, drug concentration, emulsion and tonicity of Basti Dravya are important pharmacological factors, which are the same principles adopted in different varieties of Basti explained in our classics. The application of Basti Karma is not only limited to curative aspects but also effective in prevention and pramotion due to its easy and quick action. So considering all these points I have made an effort to explain the therapeutic and pharmacological properties of Basti karma which will yield effective and better results. Details will be discussed in full paper.

*3rd yr PG Scholar Dept of Panchakarma ,AAMC, Moodbidri ** Asst Professor HOD Dept of Panchakarma, AAMC, Moodbidri *** Asst Professor Dept of Panchakarma, AAMC, Moodbidri




Study of Anuvasan Basti as an alternative Purvakarm for Snehapan in Vaman and Virechan A pilot study
By:- * Dr. Priyadarshani A. Kadus, ** Prof. Dr. Surendra M. Vedpathak

Introduction:In present days Ayurvedic physicians are showing much interest to adopt and implement Shodhan Chikitsa, but many times they face some difficulties in Purvakarm itself. Patients are not ready to take Sneha even though they are willing to undergo Vaman or Virechan. Many a times it is seen that patients are Arha for Shodhan but Snehapan is the major problem in terms of quantity, taste, smell & oiliness. This creates sudden refusal of continuance of treatment or premature development of Snehodwega; which makes physician to prepare the patient for Shodhan process mere impossible. So to convince the patient for Snehapan is the basic hurdle for the doctor. This made us to think about effective alternative to counter drawbacks, so we are taking this subject for the study. Contents:In literary search of Samhitas, it is found that Basti is not directly indicated as an alternative for Snehapan. But by considering some references, we can definitely use Anuvasan Basti as an alternative for Snehapan. These references will be illustrated in my full paper. Previous work done related to Snehan Karma of Anuvasan Basti, absorption of Anuvasan Basti and Utkletion property of Anuvasan Basti will be discussed in full paper. As on today; I have completed 10 cases of pilot study of my Ph.D work on the said topic, and Ill give details of pilot study regarding methodology, observations, results and conclusion etc. in full paper. Key words :- Alternative to Snehapan, Anuvasan Basti. . BVDU,College of Ayurved. Pune- Satara Rd. Pune - 43.



Winners of Oral Presentation

Dr. Mahesh Sharma GAMC, Mysore Dr. Shubha GAMC, Mysore Dr. Priya Kadus Pune 1st Prize 2nd Prize 3rd Prize



List of Essay Papers Received.


1. Dr. Suma S.S.Joshi 2. Dr. shwetha 3. Dr. Rosina 4. Dr. Raghavendra 5. Dr. Poorvi Athreya 6. Dr.Nagasri N.Ekbote 7.Dr .Deepa Patil 8. DR. ASHOK M. BAMMANAKATTI 9. Dr. ABHISHEK BHATTACHARJE

10. Dr. Rupanjali choudhari



Winners of Essay Competition

Dr. Huidrom Rosyna - 1st Prize Govt. Ayurvedic College, Assam Dr. Abhishek Bhattacharjee Dr. Deepa Patil Belgaum 2nd Prize 3rd Prize



Dr. Huidrom Rosyna Govt. Ayurvedic College Jalukbari Guwahati 14 Assam

Vasti is one of the most major procedures in Panchakarma therapy. In fact, it is the most important item among the Samsodhan karma. It is not limited to intestine or not only meant for samsodhan, rather its action are unlimited. Vasti is regarded as the best among the other karmas like snehan, swedan, vaman, virechan. Because other karmas are limited but the actions of vasti is unlimited1. With the different combinations of varieties of dravyas it acts as sodhan, saman, increase the sukra, make the person fat which is thin, makes the obese person thin,improves the vision, vaya sthapan, etc2 The term Vasti is thus named as it is derived from the fact that the Vasti Yantra or the apparatus used for introducing the medicated materials is made up of Vasti or Urinary bladder of Sheep, Cow, Buffalo etc.3

Importance of Vasti
Vasti is mentioned as the best therapy for the alleviation of Vata. It can remove all the disorders create by vata. Thus it is very important to put a light on the functions done by vayu in the human body.Let us describe some of the important functions of vayu mentioned in classics. It is mentioned that the abnormalities occurs in the Sakha (i.e. rakta, mamsa, meda, asthi, majja and sukra dhatu & twaca), Kostha (Mahasrota, shareera madhyam bhag, amasaya & pakvasaya) or abhyantar roga marga. Marma (Mutrasaya, Hrdaya, Murdha, Kantha, Nabhi and Guda) or madhyam roga margaja. Urdhavajatugatra, whole


organs as well as the diseases that occurs in the periphery. All these abnormalities are due to vayu itself. There is no other cause or reason to create these diseases because this vayu is responsible for destroying, binding and removing of the mala, kapha, pitta, mutra, sweda etc. So vasti is the only therapy to pacify the vata and there is no other therapy or aushadhis. Thus vasti is regarded as the whole treatment and some Acharyas mentioned as the half treatment4. Vayu is situated all over the body from head to feet, but its functions can be seen and observed in the region of Pakvasaya. So Pakvasaya is regarded as the main seat of Vata. When Vasti is given in the Pakvasaya it cuts off the entire pathogenic root of the vata. Thus vata is overcome there and the disorder of vata in other parts of Fig. 1. (Courtesy byisRoss and Wilson the body : pacified automatically. This is like that the tree cut at the root of the tree gets definite destruction of its other parts like stem, branches, aerial roots, flowers, fruits, leaves etc5. (Fig. 1) Pitta is lame (incapable of independent movement), kapha is lame, so also are the other seven dhatus, all these are driven by vayu from place to place like the clouds in the sky by the wind6.This indicates that functions of pitta, kapha, dhatus are controlled by vayu and vayu itself. Thus in order to control vayu, vasti is the prime treatment. It is found in other reference that vayu maintained the vital activities in our body. Its functions are unlimited, from the higher function to the lower function, from the digestion to the circulatory system, sensory system, gastro urinary system, excretory system etc. If any abnormality occurs in the said things, vayu is the primary cause. So to win vayu, Vasti is the best therapy7. Vayu is the master in the aggravation of the three doshas and when it is much advanced and afflicts the body, no other remedies except vasti can checked its force or control it, just like the borders of the ocean for controlling the waves produced by the wind8. For eg, In Demyelinated Peripheral Neuropathy, there is degeneration of the neurons. This is due to the dryness of the particular nerves which can be said that the rukshata guna of vata increases which results in the cracking of the neurons. If Sneha vasti is given in this type of defect, it gives snehan to this particular site. Thus the ruksa guna decreases and snigdhata increases. This ultimately results in the regeneration of the nerves.
Anatomy & Physiology, 8th Edition, P -140)



Types of basti. Vasti are divided into1. According to substance usedAnuvasan and Asthapan or Niruha vasti9 The word Anuvasan means that which remains inside (vasa) the body for a long time (anu) without causing harm. This can also be given daily (anudina) without any side effects hence it is called as anuvasan. It is of two types Sneha and Matra vasti10. Niruha is so called because it expels the doshas or because it makes the body free from diseases,it is also called Asthapan because it retards ageing maintains the life span. 2. According to Route of administrationPakvasaya, Garbasaya, Mutrasaya, Vrana Vasti. 3. According to Mode of actionSodhan, Lekhan, Snehan, Brimhan, Utkleshan, Saman, Rasayan and Vajikaran vasti. 4. According to the NumberKarma vasti, Kala vasti and Yoga vasti. Different types of vasti mention in classics1. Sodhan vasti- Sodhan vasti is that type of vasti in which the abnormal doshas and malas are expelled out from the body eg. Vaitaran vasti etc. 2. Lekhan vasti- That which reduces the fats and makes the body scarifies is lekhan vasti. 3. Snehan vasti- That vasti which gives with maximum amount of oil is sneha vasti. 4. Brmhana vasti- That vasti which tonifies the body and increases the body bulk. 5. Utklesana vasti- That vasti which increases the vitiated doshas to its maximum limits is utklesana vasti. 6. Samana vasti- That vasti which pacifies the vitiated doshas is Samana vasti. 7. Rasayan vasti-The vasti which is given in order to delay the aging process is rasayan vasti. 8. Vajikarana vasti-That vasti which is given to increase the sukra in our body is vajikarana, vrishya vasti. 9. Samgrahi vasti- That vasti which is given to stop the picchasrava is sangrahi vasti. Eg. Piccha vasti.



Doctrines of Mode of Actions of Vasti Therapy

In order to know the doctrine behind the vasti therapy, it is important to know the intestinal absorption and its secretion, the specific receptors present in the wall of the intestine, the Enteric Nervous System along with its relation with the Central Nervous System, the blood supply (systemic supply in relation with intestinal circulation, venous supply and arterial supply along with lympathic supply, portal circulation in relation with intestinal circulation). Nature of Intestinal Wall, its Absorption and Secretion The wall of the intestine is made up of following layers from inner to outer side1. Mucous membrane (innermost layer) consists of - a lining epithelium - a layer of connective tissue, the lamina propria, that supports the epithelium - a thin layer of smooth muscle, Muscularis mucosae 2. Submucosa- A layer of loose aereolar tissue in which the mucous membrane is rested on. 3. Muscularis externa A thick layer of muscle that surrounds the submucosa which keeps the gut wall to maintain its strength and form. 4. Outermost is the serous layer or adventitial layer which covers the muscularis externae. The epithelial lining is made up of striated columnar cell. This cells main function is to absorb excess water and electrolytes from intestinal contents. The goblet cell which is present in the epithelium secret mucous whish lubricates and makes easy passage of the content. It secretes antibodies (Ig A) also. Some cells which acts as an endocrine functions are also seen scattered in the epithelial cells like Argentaffin cells or Enterochromaffin cells. The absorption process of the substances by gut wall is done by1. Active transport imparts energy to transport the substance to the other side of the membrane. In this type,Lipid soluble substance are transported like oxygen and carbon dioxide. 2. Diffusion means simple transport of substances through the membrane as a result of random molecular movement .In this,substances which are soluble in water and insoluble in lipid are transported like Ca, Na+, Cl-, Glucose.etc.



3. Transport by solvent drag means that any time a solvent is absorbed because of physical absorptive forces that flow of the solvent will drag dissolves substances along with the solvent. Specific receptors present in the wall of the intestine 1. Chemo receptors Receives the chemicals present in the vasti dravyas like Na+, Cl-, glucose etc.thus activated this particular receptor. Vasti dravyas contains certain chemicals depending upon their composition. So it stimulates the chemo receptors. 2. Osmo receptors This is particular for the osmotic pressure. The vasti dravyas given in the pakvasaya has greater osmolality in compare with the fluid present there thus attract the fluid to come towards the dravyas. Due to this, osmo receptors are activated. 3. Thermo receptors These receptors are meant for hot or cold things. The vasti which is given in the form of medicines are always in the luke warm manner. Thus vasti activates these specific receptors and stimulated. 4. Noci receptors Special for pain and irritation. The vasti especially the lekhan vasti are irritating in nature. These types of vasti create the intestinal wall irritation and activate these receptors. If irritation occurs than there is inflammation in the particular site. Thus the blood circulation also increases. This in turn results in the good processing of exchange or transport system of cells. 5. Pressure receptors This receptor mainly acts on the pressure, the contraction and expansion of the gut, by how much pressure the vasti material is pushed inside. If given in constant pressure (not too slow nor too fast), the gut stressed like a balloon which results in proper expansion due to the filling of the substances in the gut. That is why vasti is always given in constant pressure. Thus activates this receptor.

Enteric Nervous System

In Ayurveda it is well defined that the vata governs all the neuro- impulsive activities. But it is not right to compare the vata system of Ayurveda with Nervous System as in modern medicine. But it can be safely stated that most of the neuro impulsive activities of the living bodies are the attributes of the Vata System. Ayurveda classics emphasize that the Vata is the Master dosha and hence Vasti karma is the Master therapy for all the major


aliments afflicting the body. Thus Pakvasaya being the main seat of vata, is the important part of the body which governs the functions of the entire body. If we compare these old age concepts of Ayurveda with the recent developments in the knowledge of Enteric Nervous System as Gut Brain and influence of Vasti karma, it will opened the bright rays of knowledge.

ENS is a collection of neurons in the GI tract that constitutes the Gut brain and can function independently without the help of Central Nervous System. This system controls the motility, exocrine and endocrine secretion and microcirculations of the GI tract. It also involved in regulating immune and inflammatory processes. ENS structurally was considered to be the part of autonomic component of the peripheral nervous system where the neurons in gut wall were conceived to be post ganglionic parasympathetic neurons. The ENS contains over 100 million neurons comparable to be number of neurons found in the spinal cord. The ENS is conceived as a displaced part of the CNS which retains communications with it through sympathetic and parasympathetic afferent and efferent neurons. (fig:- 2 and 3).

Fig. 2 & 3 (Courtesy by: Guytons Medical Physiology 10th Edition P-698 & 699)

The nerve cells body in the ENS is grouped into small ganglia which are connected by bundle of nerve processes forming two major plexus viz 1. Myenteric (or Aeurbachs plexus) extends through the entire length of the gut and lies between the longitudinal and circular layers of gut muscle. It provides motor supply to the two layers of muscles as well as the secretomotor innervation to the mucosa.


2. Submucous (or Meissners plexus) located in the submucosa between the circular muscle layer and the muscularis mucosa.

Interconnection between CNS and ENS

Even if the ENS function independently of CNS, it is also necessary to note that CNS plays an important role in coordinating the diverse functions of the ENS. ENS is well connected to the central autonomic neural networks in the CNS through both sensory and motor pathway of the sympathetic and parasympathetic nervous system. When the vasti is given in the pakvasaya, the receptors are stimulated and activated. This in turn activates the ENS. If the ENS is stimulated automatically the CNS is also stimulated.As CNS is the controller of all the neurological functions of the body, Vasti indirectly stimulated CNS. Thus all the Neurological sign are improved significantly if vasti is given properly.

Mode of action of Vasti Karma with examples and relation with modern interpretationBrimhana vasti The vasti which is given for the purpose of nourishing the dhatus of the body is brimhana vasti. When vasti is given in the pakvasaya, substance like Cl-, Na+, lipids, glucose, minerals that are present in vasti dravya is absorbed by the epithelial cells through active transport, diffusion process. Substances which are soluble in lipid like O2, CO2 and the lipid itself are directly diffused through the cell membranes without passing through the pores. Because these substances permeate all areas of the capillary membrane without any difficulty. On the other hand non- lipid soluble substances i.e water soluble like Na+ ions, Cl- ions and glucose which are soluble in water but cannot pass through the lipid membranes of the endothelial cells (fig:- 4, 5, and 6). It then enters into the portal circulation and goes to the heart


where it circulates to all parts of the body, thus nitrified the body by its essence(fig:- 7 and 8). This mechanism can be compared with the concept of ancient theory Kedara Kulya Nyay11 and Khale Kapot Nyay12, chemicals that are received by the special receptor and nutrients are distributed to cells according to their needs. It can be said that the water that is poured to the roots of the plants spread to the whole tree by its power13. After entering into the intestinal cells they triggered and activate the specific receptors present in the intestine. For eg. Thermo receptors are activated and stimulated by the temperature of the dravyas as it is always given in the form of luke warm. Saindhava lavana which is mainly composed of Na+, Cl- ions stimulate the chemoreceptors. As the osmolality of the vasti is greater in compare with the osmolality of intestinal fluid, it activates the osmoreceptors of the intestine, pressure receptors are also activated due to the pressure coming from outside through the pakvasaya.

Fig. 7 & 8

Sodhana Vasti Sodhana vasti is given in order to detoxify the body. Different types of sodhana vasti are mentioned in the Ayurvedic classics for eg: Vaitaran vasti, Utkleshan vasti. It is given in order to remove the toxins from the cells. The Sodhana dravya are irritant in nature, it can penetrate deep inside the cells. This
Fig. 9


irritated the wall of the instestine and creates inflammation of the intestinal wall. If there is inflammation automatically there will be more and more blood supply. This also creates the serous fluid to increase. This increased in circulation results in the transportation and exchange system of the waste materials. The waste, toxic substances that are present in the cells are filtered into the lymph capillaries and finally drain into the lymphatic system (fig:9). Thus the toxic, noxious substances are waste out totally from the body. Therefore Sodhan vasti removes all the impurities from head to feet by its power, just as the sun remaining in the sky draws out the moisture from the earth14.

Reasons behind the concepts of Karma, Kala and Yoga Vasti:

Why the physicians give Anuvasan vasti and Niruha vasti together? The cells is composed of nucleus and cytoplasm separated by a cellular membrane. This cellular membrane is semi permeable in nature and lined by a lipid bilayer and glycoprotein. Anuvasan vasti is mainly composed of oily substances, when Anuvasan vasti is given to the patient it enters the cells causing partial rejuvenation of cell organells and cell membranes, mix up with the lipid soluble products inside the cells component. This combination makes the cells nutrified and expands up to maximum stage within its physiological limits. Why Niruha vasti is given after Anuvasan vasti? As Niruha vasti is mainly given to expel the dosha present inside the body, its function is to detoxify the cells. The meterials or noxious chemicals inside the cells which is already in combine form with the chemicals of anuvasan vasti are taken away by Niruha dravyas.All the mixtures are thus removes and expel outside the cells after Niruha vasti. This makes the cell to shrink or contract for some period. Therefore, Anuvasan vasti given along with Niruha vasti helps the cells to expand and contract again and again till the procedure continues. This continues alternate movement i.e. expansion and contraction helps the cells for proper contraction and proper locomotion of the cells which ultimately results in proper functioning of the cells.



CONCLUSION To specify the mode of action of vasti therapy is very difficult. Vasti is specially indicated to treat and normalized the abnormal vayu as without the involvement of vayu no diseases can be settled down in our body. Beside this vasti is also used for different kinds of anabolic and catabolic purpose. So, vasti therapy can worked with the help of Enteric Nervous System, active transport system of gut, blood supply of gut viz Portal venous circulation, renal venous circulation, lymphatic drainage and inferior venacaval drainage. As this therapy is practicing since the time of immemorial and practically observed that it has different mode of action.

1. Su. Chi 35/1 2. Su. Chi 35/1-2 3. Su. Chi 35/1 4. As. Hr.Su 19/85-86 and Ch. Si 1/37-38-39 5. Ch. Su 20/13 6. Sa. Pr 5/25 7. Ch. Su 12/7 8. Su. Chi 35/29-30 9. Su. Chi 35/17 10. Su. Chi 35/18 11. Su. Su 14/10 12.Su. Chi 35/27 13. Su. Chi 35/24-25 14. Ch. Chi 15/16-17 Bibliography1. Charak Samhita by Kasinath Pandey and Gorakhnath Chaturvedi 2. Sushrut Samhita by Kaviraj Ambikant Dutta Shastri 3. Astanga Hridaya by Brahmananda Tripathy


4. Sarangadhar Samhita- A Treatise on Ayurveda by Prof. K. R. Srikanta Murthy 5. Panchakarma Therapy by Prof. R. H. Singh 6. Panchakarma by R.Vidyanath 7. Ayurvedic Panchakarma by Prof.Subhash Ranade and Dr. Avinash Lele 8. Ayurvedaya Panchakarma Vigyan by Vaidya Haridas Shridhar Kasture 9. Sareera Kriya Vigyan by Rama Sundara Rao 10. Textbook of Medical Physiology by Guyton and Hall 11. Anatomy and Physiology in Health and Illness by Ross and Wilson

Kedara Kulya Nyay11 According to this Nyay, the nourishment of dhatus is by transportation process just as different fields are irrigated from the same canal passing through those fields one after another. Ahara rasa reaches rasa dhatu through rasavaha srotas, there it nourishes rasa dhatu and attains the characteristics of rasa dhatu, and from there it goes to rakta dhatu through raktavaha srotas and nourishes rakta dhatu. Like this the same aahara rasa circulates from tissue to tissue to nourish them one after another. Khale Kapot Nyay12 Khale Kapot Nyay means selection of individual items of requirements by the individual dhatwagnis from the same pool of aahara rasa which contain all the nutrient principles just as the Kapota coming from different directions and distances to the heap of the paddy and fly away to their own places of dwelling either early or later depending upon the distance and direction they require to travel.




Dr. ABHISHEK BHATTACHARJEE 2nd Year MD(Panchakarma) S.V.Ayurvedic College ,Tirupati, AP. E.mail : Mobile no : 08121355232

Ayurveda the most ancient system of medicines believes the human body as the combination of doshas or the basic biological humors, dhatus or the body tissues and malas or the excretory products. Doshas denote the physiological state of the person and are the basic factors for the maintenance of health. Any derangement in the doshic level is the main factor for the causation of disease. According to Ayurveda the doshas are 3 in number viz., Vata, Pitta & Kapha and the functions of Vata, Pitta and Kapha in the body are similar to that of the functions of Air, Sun & Moon of the external universe respectively. Vata is the dosha responsible for all types of movements of the body both at micro and macro levels. All digestive and metabolic activities along with production of energy are controlled by Pitta. Kapha helps in the nourishment of the body, tissue repair, new tissue formation and all other anabolic activities thus maintaining the strength, vigour and immunity. Though all the

doshas perform their specific function but the main controlling authority not only for other dosha but also for dhatus and malas is vata which is the supreme power to maintain the total body functions and homeostasis. So it is told that pitta, kapha, malas and dhatus become lame without the proper functioning of vata. Like the clouds which are moved by wind in the same way all the activities of pitta, kapha, dhatus and malas are regulated by vata. So all the Ayurvedic classics have given due importance to vata in maintaining health. Vasti which is considered to the best Sodhana chikitsa of vata, also gets equal importance among all therapeutic modalities.To show the therapeutic importance of



Vastikarma Ayurvedic Acharyas have mentioned it as chikitsardham or half of the total treatment and some others even mentioned vasti alone as the total treatment. Though Vasti is considered as the best treatment for vata, but acharya Sushruta clearly mentioned that vasti is beneficial not only for diseases due to vata, but also in diseases caused by aggravation of pitta, kapha, Rakta and even in conditions of samsarga and sannipata i.e. diseases due to aggravation of more than one dosha. In the same context of describing about the wide therapentic use of vasti Acharya Charaka told that without the derangement of vata production of diseases of Shakha, Kostha or marma-asthi-sandhi i.e. diseases of the different rogamargas are not possible. It is presumed that vata is the root cause of all the diseases as there is some involvement of Vata, without which other doshas cannot perform their physiological as well as pathological functions. So in any diseased condition if control over vata is achieved, then treatment becomes easier and this is the reason behind advocation of vasti as the supreme treatment. In almost all diseases different vastis may be the treatment of choice depending upon the other doshas predominantly involved. To fulfill this need acharyas have developed different types of vastis for different diseases and different doshik conditions. As pakvasaya is the main seat of vata and vasti is administered directly to pakvasaya, thus expels out the vaikarik or pathological vata from its root. Due to the normalcy of vata in its prime site, the vata of the rest of the body also comes to the normalcy, as a result the disease process gets subsided. Acharya Charaka mentioned that vasti reaching the nabhi pradesha, kati, parshva and kukshi expels out the purisha and accumulated doshas after churning them. On the other hand Acharya Sushruta has clearly mentioned that though vasti is administered in the pakvasaya but the active principles of vasti dravya spreads all over the body through the minute srotas in the same way water reaches to all parts of the plant from its root. The virya or active principles of vasti reaches the whole body through the micro strotas and bring all the vitiated doshas to pakvashaya and expel them out with purisha in the same way as the sun though staying thousands of light years away from the earth, evaporates water from the earth surface. Acharya Chakrapani also mentioned the same thing while commenting on Charaka. He mentioned, when vasti is administered to a person lying down in left lateral position, due to the presence of grahani and guda in the left side vasti dravya can easily reach the grahani


and thereafter spread through out the body due to the sukshma guna and exerts its effects over the whole body. So from the wide description of vasti from the classical texts it can be easily assumed that though administered in the rectum just like enema given in the modern medicine to clean the bowels, the effect of vasti is not limited locally like that of enema. On the contrary vasti has a broader systemic effect. To establish these effects of vasti and its mechanism of action many hypothesizes have come. The function of vata which are very much similar to that of the nervous system and all the vata vyadhis also shows some involvement of the nervous system. So vasti which is the treatment of choice for the vata vyadhis should have some effect over the nervous system. For all most all neurological functions brain and spinal cord are the main centres, where as for all vatic functions the main seat is below the umbilicus i.e. the large intestine. Naturally to eliminate the vitiated vata dosha the main procedure is vasti i.e. administration of vata hara drugs into the large bowel through the rectum. Confusion arises to the modern rational thinking that in any neurological disorder generally the pathology lies in the brain, spinal cord or its related areas, whereas Ayurveda believes in that it is all vata and its deranged activity leading to such disorders and vatas main seat is large bowel i.e. pakvasaya. Now how to establish this head and tail relation. The modern science is grossly apparent, solid and visible. Ayurveda is strong in principles, experience and result oriented. To bring back these visibly divergent facts into unity an integrated approach is needed to be adopted. When we look at the micro anatomy (electron microscopic) of gut it reveals scattered, frequently solitary hormone producing cells of stomach, intestine and pancreas. These are known as Gastro entero pancreatic (GEP) endocrine system able to produce peptides and amines as active as hormone or as neurotransmitters, and are all derived from neuro

endocrine programmed cells of ectoblastic origin. Gastro entero pancreatic system release their secretions in response to nutrient stimulation from the circulation and lumen and have the potential to secrete into the circulation and lumen too (1). These specialized cells of gut



are known as gastro enteric endocrine cells, entero endocrine cells, Enterocromaffin cells, etc. As they act exactly like that of neurons of the brain so they are designated as paraneuron (2). The GEP endocrine cells are presumed to have receptor sites on their surface, adequate stimulation to which by Secretogogues triggers stimulus secretion. The GEPE cells hence also can be termed as Recepto secretory cells, allowing specialized regions of their plasma lemmae to detect and respond on luminal stimuli directly. Thus the gut can be regarded as the largest endocrine organ of the body (3). It is perhaps better to regard it as a region in which neural, paracrine and endocrine control activity are intimately linked. Thus Ayurvedic Vata System and the modern GEPE can be brought together because of their location and function. To correct the vata functions when vasti dravyas either predominantly of decoction or oil along with rock salt, honey etc., passed through lower GIT probably stimulate the cells and act as Secretogogues thus compensating neurological deficit and improving the functions with immediate effect. Another concept of mechanism of action of vasti Karma is through stimulating the Enteric Nervous System. Which is otherwise known as the gut brain. ENS is a subdivision of the peripheral nervous system, that directly controls the gastro intestinal system functions. The ENS is capable of autonomous functions such as the co-ordination of reflexes. It receives considerable innervations from autonomic nervous system and often considered as a part of ANS (4). ENS consists of some one hundred million of neurons, almost equal to the number of neurons in the spinal cord. The ENS is embedded in the lining of the gastro intestinal tract. The neurons of ENS are collected into two types of ganglia myenteric (Auerbachs) and submucosal (Meissners) plexuses are located in submucosa. The enteric nervous system originates from the neural crest cells that colonise the gut in the intra uterine life. It becomes functional in the last third of gestation in human and continues to develop following birth. Enteric neurons also interact with gastro intestinal endocrine signaling system and with extensive intrinsic immune system of the GIT. Enteric nervous system normally communicate with the central nervous system through the parasympathetic (eg. Via the vagus nerve) and sympathetic (eg. Via the prevertebral ganglia) nervous system. Sensory neurons of the ENS monitor chemical changes within the GIT as well as streatching of its wall. Enteric motor neurons govern contraction of GI tract smooth muscle and activity of GI tract endocrine cells. ENS also makes use of more than thirty neurotransmitters, most of


which are identical to the ones found in CNS such as acetylcholine, dopamine, serotonine etc. The enteric nervous system has the capacity to alter its response depending on factors such as bulk and nutrient composition (5). Thus vasti dravya when administered into the rectum may stimulate the sensory system of the ENS due to its chemical composition and pressure affect over the large bowel. As the total nervous system is interrelated so this regular stimulation to ENS may have some positive effect over the CNS also and in this way the neurological deficits may be corrected. Other than the local stimulation some drugs may get absorbed through the large bowel mucosa and may enter into the systemic circulation through superior, middle or inferior haemorrhoidal veins. Drugs absorbed into inferior and medial haemorrhoidal veins (about 50%) bypass liver and enters into the systemic circulation without any change (6). So there is a less chance of destruction of the active principles of vasti dravyas by different metabolic reactions. So the action of the drug also may be faster. Same type of faster effect than oral administration is seen when diazepam, phenobarbitone etc drugs are used as anal suppository (7). Again drugs absorbed into superior haemorrhoidal vein have to pass through the hepatic portal circulation. Absorption through the gastro intestinal mucosa occurs by active transport and by diffusion. Further more this diffusion obeys the usual law of osmosis. So when a hyper osmotic solution is present in the lumen absorption towards it from the blood and in presence of hypo-osmotic solution absorption from the solution occurs (8). It may be considered that niruha vasti is hyper osmotic which facilitates absorption of morbid factors i.e. endo toxins into the solution and produces detoxification during elimination whereas the sneha vasti and other nourishing vastis contain hypo osmotic solution facilitating absorption of active principles into the blood. In different studies the administration of niruha vasti shows a decline in the pyruvic acid level which results in higher vit B-1 level (9). Moreover a reduction in the B1 level leads to degeneration of myelin seath, neurological disorders and ailments of the digestive system. Thus it may be the reason of the action of vasti in neuro muscular disturbances. On the other hand colon has a large number of non pathological bacterial flora, which bestow the body by producing certain factors of B groups of vitamins and K. These


intestinal flora maintains the normal physiology of the gut and helps in proper absorption of nutrients and thus have great systemic effects . Other than these , they control symptoms of diarrhea and various forms of gastroenteritis by reducing the duration of treatment and frequency of stools (10). Animal studies have shown the efficacy of certain intestinal flora in lowering serum cholesterol levels (11). Although not confirmed effect, some strains of lactobacillus bacteria may result in modest reduction of blood pressure (12). There is evidence to suggest that they may improve immune function by increasing the number of IgA producing plasma cells, by improving phagocytosis as well as increasing the proportion of T-Lymphocytes and Natural Killer cells (13). Lactobacillus bacteria may modulate inflammatory and hypersensitivity responses , an observation thought to be at least in part due to regulation of cytokine function (14). In laboratory investigations some strains of these lactobacillus bacteria have demonstrated anti-mutagenic effects and may play an important role in preventing colon cancer (15). There are so many other conditions like colitis, irritable bowel syndrome, Helicobacter pylori infections, Lactose intolerance etc. where intestinal bacteria may show beneficial effects. Different studies have shown that proper growth of these bacteria depends on the particular ecological environment of the G.I.Tract. High fat content, metabolizable sugars, and buffering capacity of the matrix helps to protect these bacterial flora (16). So vasti dravya, which is generally rich in sugar and fat contents may provide a favorable environment for their growth. Other than this, researches have shown that this flora flourishes abundantly on administration of sneha vastis (17). Thus the pharmacodynamics of vasti cannot be shown related to only one system as the effect of vasti is multi systemic and multi dimensional. It can perform different actions like excitatory, purificatory, restorative, nutritive, extractive, rejuvenative, aphrodisiac etc. So, Ayurvedic Acharyas have very rightly praised it as chikitsardham and sarvam chikitsam api vastimeke i.e. half of the whole treatment and vasti alone is the treatment.





(1) Mechanism of release of gastro entero pancreatic endocrine cells, Norman S.Track , World Journal of Surgery(1979). (2) Harrisons Principles of internal Medicine, 15th Edition. (3) Gastro entero pancreatic endocrine system - a cell biological approach, T.Fugita(1974). (4)&(5) Principle of Anatomy and Physiology by: Gererd J.Tortora & Bryan H. Darrickson, 12th Edition. (6)&(7) Alternative route of drug administration advantages and disadvantages, American Academy of Paediatrics(1997) (8),(9)&(17) Principles and practice of vasti by: Dr.M.R.Vasudevan Nampoothiri & Dr.L.Mahadevan , 1st Edition(2000). (10) ,(11) ,(12) ,(13), (14) ,(15) ,(16) Probiotic from Wikipedia, the free encyclopedia.



Comprehending the mode of action of Basti karma through illustrations and interpretation
By - Dr .Deepa Patil *
1st year PG Scholar, Department of Panchakarma KLE Universitys Shri B. M. Kankanawadi Ayurved Mahavidyalaya, Shahapur, Belgaum

Basically the Ayurvedic treatment aspect are divided in two types i.e. Shamana chikista and Shohana chikista.Shamana is mode of treatment where the ayurvedic medicines are given to pacify the doshas, where as shodhana is a mode of treatment where morbid doshas are removed through the body .In Shodhana chikista Panchakarma play an important role which includes the vamana, Vireechana, Basti Nasya and Raktamokhsana.and this is considered as Doshaha kadachit kupyanti jita lamghana pachanaihi Jitaha smshodhanaiyreshu na tesham punarudbhva 1 The Basti karma is most important therapy in Panchakarma, with wide scope of applicability. It has effects of purification, pacification, rejuvenation, etc. So it has got utmost importance in Panchakarma procedures and is said to be Ardha or sampurna chikista which is coated as 2 Siravyadha chikistardham shalyatantrai prakirtitaha Yathah pranahitam samyag Basti kayahikistite The term Basti can be defined as Bastinam diyate eti basti. It means an instrument to designate procedure3. It can be used from Paediatrics to Geriatrics It has got multi dimensional therapeutic effect. It is unique treatment for Vata4, Kasyapa considers BASTI as AMRITAM due to its wide range of application from infants to aged through which any goal can be achieved. So on this basis Basti can be divided in many types as per need and requirements so one can utilise these whenever get needed.


In our classics we get much age limitations while performing the Panchakarma along with indications and contraindications. Eg Nasya should not be performed below 7 yrs and above 80 yrs, Vamana & virechana should not be performed below10 yrs and above 70 yrs etc5. But for Basti Karma we cant get age limitation while performing Basti Karma.Apart from this we not only get wide applicability but also scientific explanations in each and every step of Basti karma As in POORVA KARMA it is mentioned that basti should be given in Vamaparswasthita left lateral position with straight left leg and with right leg flexed at knee joint by which guda and grahani comes in same path in the left side of the body so it is easy to penetrate the Basti dravya into the pakwashaya6.Also in rectum three Valves- a) Superior b) Middle c) Inferior in which Middle one is important, which is situated in the right side of rectum, because it plays an important role not only in defecation process but also protects valve and helps in the gravity because of Anatomical slope, which will facilitates passing of Basti Dravya across the rectum to other areas7. Literal Meaning of NIRUHA VASTI is one which is capable of eliminating the doshas from the body. It is also called Ashtapana Vasti because it sustains life. Nirooha is of several types: 1) Ksheeravasti 2) Yapana basti 3) Vaitharana basti 8. Where the drugs like Makshita,lavana,sneha,kalka,kwatha used which are acts by various means 1)Yogavahi, Sukshma srotogami guna of Madhu which contains Fructose, Glucose, Sucrose, Maltose etc Proteins, Vitamins , Minerals,Enzymes & Amino acids. Natural product with high nutritional & medicinal value. 2) Madhur, laghu, tridoshahara, anushna sheeta & less abhishyandi Lavana have the properties 21 essential & 30 accessory minerals.which helps for regulating acid alkaline balance. Maintaining osmosis, activation of ATP phase 3) Sneha gives potency to whole combination. Helps to disintegrate malas- increasing osmotic permeability of solution. 4) Kwatha maintains volume of fluid, helps in spreading & cleaning. So practical we use these Bastis in day to day practice as in various diseases. Eg degenerative changes like OA Tikta rasa ksheera basti, IVDP - EMN Metabolic,DM Madhutailika Basti HYPERLIPIDAEMIA - Lekhana basti, Neurological Sciatica - Vaitarana basti, EMN and Yashtimadhu Ksheera Basti. Hemiplegic - Dwipanchamooladi, dashamoola & Mustadi. Rheumatism- Kshar basti, ENM Orthopedic- Lumbar spondylosis: Madhuyasti ksheerabasti Infertility- Vrusya basti, Yapana . IBS - Takra vasti, Muscular dystropy:


shashtika shali pinda sweda and matra Basti. Asthapana and anuvasanana are excellent remedy for vata9. In our classics there is a reference of Rakta basti which used in acute management in those days. Due to rapid advancement in the technology this was not practiced As Basti has wide range of applicability but our acharyas mentioned the action of Basti karma in minimally like as soon as Basti enter into the Pakwashaya, it counters the vata successfully, overcome spontaneously and subside the vitiated vata elsewhere in the body. This is compared to the uprooted tree which gets destructed gradually one by one10. But we get abidance of explanations from allied science from which we can understand an action of Basti karma by various means as follows. 1. GUDA MOOLAM HI SHAREERAM where we give Basti dravya from rectal route so given drug cross rectal mucosa 1.Upper rectal mucosa- Sup.hemorrhoidal veinPortal circulation. 2. Lower rectal mucosa- Middle & Inf.hemorrhoidal vein- Systemic circulation. So we see effect in diseases like Arsha, Bhagandar, malasanga etc 2. AMOUNT OF VASTI DAVYA It can be given up to 12 prasruta (approx 1500ml) which is capable of reaching up to duodenum where it get absorbs and produces action so beneficial in diseases like balaksha,mamsaksha,shrukaksha where Brumanha Basti get acts.

3. NIRUHA BASTI: - As it contains kwatha dravya so it acts as Hyper osmotic means it facilitates absorption of endotoxins in the solution- Detoxification. Whereas AnuvasanaHypo osmotic- absorption in blood so effective in kshushiroga,adhamana, udavarta etc

3. ENTERIC NERVOUS SYSTEM - ENS cells in the gut communicate with the brain via the Sympathetic nerves that pass to and from the gut through the transformer called Sympathetic ganglia These nerves connect to spinal cord Then to the base of the brain In addition, we find parasympathetic link to the base of the brain via the vagus nerve from the upper gut and sacral nerves from colon. So effective in various vatavyadhi like ekanga vata, sarvanga vata erc



4. GI DISORDERS - The gut and brain use Neuro Transmitters to send the electro chemical message from one another by way of these nerves. Functional Gastro Intestinal Symptoms are not necessarily the result of dysfunction of Bowel, but may also be due to disturbance in the brain gut pathways. Emotional and psychological factors play an important role in the functional so effective in atisara, adhmmana, krumikostha, antrakujana etc diseases

5 VAGUS NERVE - Gut contains Millions Neurons like that of the Spinal Cord Major Neurotransmitters like Serotonin, histamine, Nitric oxide are in the Gut. CNS & ENS are communicated by a cable called VAGUS NERVE. So effective in arditha, pakshaghata` ktishoola, manyasthamba, hanugraha etc conditions

6. LARGE INTESTINAL ABSORPTION - Water Electrolytes some vitamins are also absorbed through the colon Colon bacteria in normal condition, produces Vitamin B1, 2, B12 & K. Similarly some of the Nutrients of BASTI can also be absorbed in to the system.

7. VASO ACTIVE INTESTINAL PEPTIDES (VIP's) - It is a hormone produced in the various parts of the body including gut, pancrease, and hypothalamus of brain. The role of VIPs on Digestive System Induces smooth muscle relaxation Stimulatory secretion of water into the pancreatic juice and bile Dilates the peripheral vessels Increases the intestinal motility BASTI may act through VIPs, it Hormonises the VIP Production.

8 BENEFITS OF PROBIOTICS - .Around 400 varieties of Bacteria have been colonized in large intestines. Which live a Symbiotic life with human beings They help us to synthesize certain Vitamins like B12 & Vitamin K etc. and also detoxicate certain substances. The Basti Dravya probably facilitates the harmony in various colonies of intestinal flora. Thus improving the process of Synthesizing and detoxification. Basti removes the toxins from lower gut.

9. Its strengthen the Immune System to combat allergies, excessive alcohol intake, stress, exposure to toxic substances Most of the Immune Cells are manufactured in the Bone Marrow but they do not mature there Instead they migrate and mature in colonies & this is


seen in R.E.S. These colonies are found in the walls of intestines and also found in the Nervous System, Lungs and in the connective tissue.

10. Prevents Colon Cancer Cholesterol Lowering Effect Lowers Hyper Tension Reduces Inflammation Improves Immune Function and prevents infection Improves Mineral Absorption Prevents Harmful Bacterial growth under stress and also helps to prevent IBS & Colitis

11. COLON THERAPY - It is a detoxifying technique. This irrigates the large intestine with water and cleans out the toxins and accumulated waste lining its walls. 1. Removal of waste will improve Colon Function Digestion & Nutrient 2.Absorption Function 3. Colon Cleaning prevent carcinoma of Colon 4. Useful in constipation 5. In Colitis 6. Haemorrhoids 7. IBS 8. Mucus Colitis 9. Intestines play a critical role in the bodys immune & detoxification system High colonic irrigation kills a) Harmful Bacteria b) Parasites c) Yeast Infection & d) Virus It treats the CAUSE not the SYMPTOMS Doctors consider that Colon as the third lung because it has ability to absorb 70% of oxygen introducing to it during surgery.

12. OTHER BENEFITS OF BASTI - Basti improves the Local circulation to the Sacrum, Pelvis, and Sacral Plexus in the Lower Limbs in particular & total body in general Endogenous Stimulation. It ignites certain chain reactions from the intestines which may end in any part of the body. Thus bestow the systemic effects11. These hypothetical mode of actions are helpful for understanding the concept of Basti in various disorders so in our classics it has got utmost importance as ARDHA OR SUMPURNA CHIKISTA

References: 1. Vaidya Manorama, Acharya Vidhyadar shukla, Ravidatta Tripathi; Charak Samhita. Delhi.Chaukhamba Sanskrit pratistan; 2001. (sutrasthan 16/20) 2 Vaidya Manorama, Acharya Vidhyadar shukla, Ravidatta Tripathi; Charak Samhita. Delhi.Chaukhamba Sanskrit pratistan; 2001. (sidhhisthan 1/41)


3. K.R.Shrikant Murthy; Indutika of Astanga Sangra of Vagbhatta.Varanasi; Chaukhamba Orientila; 2006, (sutrasthan 19/1) 4. Pandita Pshurama Shastri; Sharangdhara Samhita by Pandita Sharangdhar acharya commentary of Adhamalla Dipika and Gudarha Dipika.5ed.Varanasi; Chaukhamba Orientila.2002. (Chikisthana35/3) 5. Haridas kasture; Ayurveda panchakarma vijynana, Nagpur.Baidhynath Ayurveda Bhavan 2000. 6. Vaidya Manorama, Acharya Vidhyadar shukla, Ravidatta Tripathi; Charak Samhita. Delhi.Chaukhamba Sanskrit pratistan; 2001. (Sidhhisthan 3/24) 7. 8. Haridas kasture; Ayurveda panchakarma vijynana, Nagpur.Baidhynath Ayurveda Bhavan 2000 9. 10. Vaidya Manorama, Acharya Vidhyadar shukla, Ravidatta Tripathi; Charak Samhita. Delhi.Chaukhamba Sanskrit pratistan; 2001. (Sutrasthana15/15)




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